Aims: The aim of this prospective study was to analyse the Ludloff osteotomy for its potential of correcting hallux valgus deformity. Methods: Between September 1998 and October 1999 84 consecutive patients who underwent a Ludloff osteotomy were included in this prospective study. All patients were examined preoper-atively and at a minimum follow up of 2 years according a standardized questionnaire based on the HMIS of the American Foot and Ankle Society. X-rays were taken preoperatively, at 6 weeks and at þnal follow up. Results: 75 patients were available for an average follow up of 33 months (24 to 41). The average preoperative HMIS was 52 points and at follow up 87 points. 78% of the patients rated the outcome as excellent and good. 82% of patients were painfree at follow up. Radiological evaluation revealed a preoperative average hallux valgus angle (HV) of 36û and a preoperative average intermetatarsal angle (IM) of 17û This was corrected by surgery to an average HV of 14û and an average IM of 8û. Preoperatively sesamoidposition Grade III was present I 71%, Garde II in 29%. At follow up Grade 0 was present in 60%m Grade 1 in 37% and Grade2 in 3%. There was no Grade 3 sesamoid position at follow up. Conclusions: The ludloff osteotomy is a good alternative for the correction of severe hallux valgus deformity. In elderly patients and osteoporotic bone early weight-bearing should not be allowed because of poor bone quality

Introduction: This study compares two diaphyseal osteotomies (scarf and Ludloff), which correct moderate to severe metatarsus primus varus. This is a single surgeon, prospective cohort study with clinical and radiological follow up at six and twelve months.

Material and methods: Clinical assessment included visual analogue scale questionnaires for subjective assessment and functional activities and the American Orthopaedic Foot and Ankle Society (AOFAS) score. Standardised weight bearing radiographs were analysed.

Results: There were 57 patients in each group. Both groups were similar in terms of age, gender and preoperative deformity. There was no statistically significant difference in the two groups at 6 and 12 months in subjective satisfaction, AOFAS forefoot score, improvement in functional activities and range of movements. The improvement in pain (at best) and plantar callosities at 12 months was significantly better in the scarf group (p< 0.001). The radiological results at 6 and 12 months including intermetatarsal angle (p< 0.001), hallux valgus angle and shortening of the first ray (p< 0.01), distal metatarsal articular angle and sesamoid position (p< 0.05) were significantly better in the scarf osteotomy group. There were six complications in the Ludloff group with three delayed unions, two dorsiflexion malunions and one complex regional pain syndrome. There were two wound complications in the scarf group.

Conclusion: Overall the patients who had a scarf osteotomy had a superior outcome at 6 and 12 months.

Query: In the past few years, chevron osteotomy has become more widespread in the treatment of mild Hallux valgus deformities thanks to its low rate of complications and excellent results. The results in moderate to severe deformities are not as convincing, depending on the surgical procedure used. The objective of this study was to examine the influence which the choice of surgical procedure and thus the osteotomy has on the clinical, radiological and pedobarographic results in the forefoot. Method: In a prospective study, we examined the surgical results of 140 feet treated between August 2004 and March 2005 in our clinic for moderate Hallux-Valgus deformity. In 70 patients, Ludloff osteotomy and in 70 the Scarf osteotomy was selected as the method. The patients underwent pre- and postoperative clinical, radiological and pedobarographic examination. In addition, patient satisfaction was determined using the Kitaoko Forefoot Score. Indication for performance of the osteotomy was a Hallux-Valgus deformity up to an intermetatarsal angle (IMA) of 17°. Results: The mean preoperative IMA was 14.5 °, the Hallux-Valgus angle (HVA) 31.3°. The IMA could be improved by Scarf osteomy on average by 7.6°, by Ludloff osteotomy by 8.1°. With suitable plantarisation of the 1st metatarsal head, better and more even pressure distribution in the forefoot could be achieved with both surgical procedures and the load peaks reduced overall. The complication rate was somewhat lower overall in the Scarf osteomy. Conclusion: Both the Scarf osteotomy, and the Ludloff ostetomy enable achieving of good results in moderate deformity. The extent to which one procedure should be preferred over the other could not be determined. Both procedures have advantages as well as disadvantages. Further attention to this area of Hallux-valgus surgery is definitely needed to meet the higher demands of the patients

Background: This study compares two diaphyseal osteotomies (scarf and Ludloff) which correct moderate to severe metatarsus primus varus. This is a single surgeon, prospective cohort study with clinical and radiological follow up at twelve months. Materials and Methods: There were 57 patients in each group. Both groups were similar in terms of age, gender and preoperative deformity. Clinical assessment included visual analogue scale questionnaires for subjective assessment and functional activities and the American Orthopaedic Foot and Ankle Society (AOFAS) score. Standardised weight bearing radiographs were analysed. Results: There was no stastically significant difference between the two groups at 6 and 12 months in subjective satisfaction, AOFAS score, improvement in functional activities and range of movements. The improvement in pain (at best) and transfer lesions at 12 months was significantly better in the scarf group (p< 0.05). The radiological results at 6 and 12 months including intermetatrsal angle (p< 0.001), hallux valgus angle (p< 0.01), distal metatarsal articular angle and seasmoid position (p< 0.05) were significantly better in the scarf osteotomy group. There were three cases (5%) of delayed union in the Ludloff group. Two of these healed with dorsiflexion malunion. One patient in the Ludloff osteotomy group developed a complex regional pain syndrome. There were two wound complications in the scarf group. Conclusion: Overall the patients who had a scarf osteotomy had a superior outcome at 6 and 12 months

Aims

Hyaline cartilage has a low capacity for regeneration. Untreated osteochondral lesions of the femoral head can lead to progressive and symptomatic osteoarthritis of the hip. The purpose of this study is to analyze the clinical and radiological long-term outcome of patients treated with osteochondral autograft transfer. To our knowledge, this study represents a series of osteochondral autograft transfer of the hip with the longest follow-up.