Abstract
Introduction
Hallux valgus deformity is a common potentially painful condition. Over 150 orthopaedic procedures have been described to treat hallux valgus and the indication for surgery is pain intractable to nonoperative management.
Methods
A retrospective analysis of the treatment of complex hallux valgus with bifocal metatarsal and Akin osteotomies of the first ray performed by the senior author (CC). 22 patients were treated over a three year period from 2008 to 2011, 24 trifocal osteotomies were undertaken. Hallux valgus angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA) were all measured from pre- and postoperative radiographs. The patients were also clinically reviewed.
Results
The study group consisted of 21 women and 1 man with a mean age of 53 years. The average time to follow up was 19 months. Four cases had undergone previous surgery. Average HVA correction was 26.9 degrees (p < 0.0001), average IMA correction was 12.65 degrees (p < 0.0001). No patients had postoperative infection and all osteotomies went on to union. All patients reported resolution of pain. Two patients required removal of metalwork and the distal osteotomy angulated slightly in one patient not requiring reoperation.
Conclusion
We demonstrate that bifocal metatarsal and akin osteotomies of the first ray are a safe and effective method of correcting complex hallux valgus.
