Abstract
This study reviewed the subjective, clinical, and radiological outcome of 24 patients (31 feet) treated by basal metatarsal osteotomy with a modified McBride procedure for severe (intermetatarsal angle > 150) hallux valgus, carried out at our institution with an average follow-up time of 29 months.
At the time of follow-up, 40% of the patients were very satisfied, 45% were satisfied, and 15% were not satisfied. The mean Hallux – Metatarsophalangeal – Interphalangeal scale score raised significantly from 39 points (17 – 64) pre-operatively, to 82 (39 – 96) points at follow-up (p < 0.001). The Lesser - Metatarsophalangeal – Interphalangeal scale score raised significantly from 46 points (26 – 69) pre-operatively, to 84 (33 – 97) points at follow-up (p < 0.001). The radiological angles, including M1-M2, M1-P1, M1-M5, and DMAA improved significantly (p < 0.001). 12 of these cases had a M1-M2 angle post correction > 15°. Among the 9 complications recorded, 7 were minor and 2 required an additional procedure.
The basal metatarsal osteotomy coupled with a modified McBride procedure resulted in an overall high satisfaction rate, as well as significant clinical and radiological improvements in our series. Nevertheless, the range of motion of the first MTP joint remained low: 30 – 75° in 67% and < 30° in 6%. Furthermore, the failure to correct the M1-M2 angle to < 15° in 12 cases was probably due to the severe nature of the M1-M2 angle in these patients pre-operatively (21–33°).
Basal metatarsal osteotomy with a modified McBride procedure remains a safe procedure with excellent results, both subjectively and objectively, in patients with severe hallux valgus
The abstracts were prepared by Emer Agnew, Secretary to the IOA. Correspondence should be addressed to him at Irish Orthopaedic Association Secretariat, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
