Introduction Hallux valgus (HV) leads to altered load-bearing function of the foot but there is no adequate evidence to show the restoration of load bearing function post-deformity correction where transfer metatarsalgia is the common complication. This study describes a retrospective review conducted on individuals who have undergone Mitchell and Scarf osteotomy for severe HV deformity. Method Clinical records and radiographs were reviewed. Clinical evaluation was done using American Orthopaedic Foot and Ankle Society (AOFAS) scores and plantar pressures recorded using the Musgrave system analysing the average pressure, peak pressure distribution and contact time of the various regions of foot during the gait cycle. A control group of 15 individuals with 20 normal feet was included for comparison. Statistical analysis was carried out using ANOVA and correlation tests. Results Twenty-two Mitchell and 22 Scarf osteotomies were performed on 28 patients with follow up ranging from 13 to 62 months. The average postoperative AOFAS scores following Mitchell and Scarf osteotomy were 74 and 84 respectively. Pedobarograph findings: Post-Mitchell osteotomy, an insufficiency of hallux was seen, which overloads the second and third metatarsal heads. Post-Scarf osteotomy resulted in reduced peak pressures under first, second and third metatarsal heads and hallux with reduced push off during late stance phase. More pressure is transferred through heel, midfoot and lateral metatarsal heads. The
Introduction: A retrospective review was conducted on individuals who have undergone Mitchell osteotomy for mild to moderate hallux valgus deformity. Hallux valgus leads to altered load bearing function of the foot and correction of deformity might result in shortening of the first metatarsal. Transfer metatarsalgia is one of the common postoperative complication. This study aims to look at the restoration of load bearing function of the foot post deformity correction. Methods: Patients with preoperative intermetatarsal angle of less than 14 degrees were included. Clinical records and radiographs were reviewed. Clinical evaluation done with AOFAS scores and plantar pressures recorded using musgrave system. The foot was divided into 7 regions: first metatarsal head, 2nd &
3rd metatarsal heads, 4th &
5th metatarsal heads, midfoot, heel, hallux and lesser toes. Average pressure, peak pressure distribution and contact time of all seven regions were analysed. A control group of 15 individuals with twenty normal feet were included for comparison. Statistical analysis was done with analysis of variance of the means and Pearson correlation tests. Results: Seventeen mitchell osteotomy was performed on 13 patients with follow up ranging from 14 to 66 months, a mean of 34 months. Most of our study group were females with an age range of 25 to 71 years, a mean of 53 years. The mean postoperative AOFAS scores were 87 and a median of 90 out of 100. Pedobarograph findings: Statistically significant reduced average pressure, peak pressure and contact time were noted under hallux when compared to the normal control group. The peak pressures were reduced at all forefoot regions but statistically insignificant. Otherwise, the pressure distribution, contact time and
