Many surgical techniques based on a
The intermetatarsal angle is widely used to determine whether a basal or
Introduction. Hallux valgus is a common orthopaedic complaint with multiple surgical options. There are many methods available for assessing whether sufficient translation of the first metatarsal can be achieved with a metatarsal translational osteotomy alone. None of the current methods take into account the breadth of the metatarsal. With current PACS technology a radiograph can be zoomed to any size and we postulate that by using the surgeon's thumb (or any suitable digit), as a sizing tool, a safe clinical decision can be made concerning whether a translational metatarsal osteotomy alone will provide sufficient correction. Method. We reviewed the preoperative radiographs (weightbearing AP) of twenty patients who had scarf and akin osteotomies and twenty patients with a deformity too great for scarf and akin osteotomies. The senior author (CC) taught the rule of thumb to one consultant and two registrars (total two registrars and two consultants). The radiographs were blindly randomised and the participants assessed each radiograph and decided whether sufficient translation could be achieved with a translational metatarsal osteotomy alone. The process was repeated three months later. Twenty patients were deemed sufficient for intra-user variability and significance based on a recent JBJS(A) article concerning radiographic measurements post proximal crescentic osteotomy (Shima et al. 2009). Results. Good inter- and intra- user variability was demonstrated and using the rule of thumb is a safe way of determining whether a
Introduction:
Though there are many techniques utilised in the correction of hallux valgus (HV), no single approach has been reported to be ideal for all patients to date. A great deal of controversy remains concerning the type of osteotomy, method of fixation, and inclusion of soft tissue procedures. Herein, we compared the outcomes of two different operative techniques, the minimally-invasive modified percutaneous technique and the
This study was designed to investigate
Purpose of the study: Different metatarsal osteotomies performed via a percutaneous approach can be used to correct hallux valgus. The purpose of this work was to analyse the clinical and radiographic results of percutaneous treatment of hallux valgus using a
Purpose of the study: The purpose of using
In the correction of hallux valgus, there are many different treatments with the aim to resume angular values I MF (metatarsal-phalangeal), I IM (intermetatarsal), PASA (proximal articular set angle), sesamoid position, to improve transferring metatarsal pain and the aesthetics of the forefoot. From November 2001 to November 2003, in the 1. st. Clinica Ortopedica at Bari University, 40 patients were treated for hallux valgus (nine males and 31 females). The age ranges from 17 to 82 years of age (median age: 50 years). The correction technique is based on a
Introduction: The main goal of surgical correction of hallux valgus is the morphological and functional rebalance of the first ray and correcting all the characteristics of the deformity. Historically,
Aims: The purpouse of the study is to review a series of hallux valgus treated by minimally invasive
Purpose: We compare the accuracy and precision of patient-specific plastic guides versus computer-assisted navigation for
Purpose: The purpose of this clinical trial was to investigate the accuracy of a novel method for computer-assisted
INTRODUCTION:
OBJECTIVE OF THE STUDY: Metatarsal osteotomies are common procedures for correction of hallux valgus. The aim of this study is to compare linear
This case series aim to report our experience with the use of fragment specific fixation plating system and cancellous bone autograft in the elective treatment of distal radius malunions. Fourteen patients who underwent distal radial corrective osteotomy by one surgeon were followed up retrospectively. All patients had elected for this procedure for the treatment of malunions of previous distal radial fracture. The follow up assessments include each patient’s subjective functional outcomes, the objective strength and range of motion testing, and the radiographic parameters. These subjective functional outcome data collected as measured by the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) were compared with each patient’s pre-operative status. The motion, strength and radiographic appearances were assessed in relevance to the contralateral arm.
The Kramer osteotomy for hallux valgus deformity was described in 1990 and has been performed by the senior author in our unit since 1999. The procedure involves a wedge excision of bone and lateral displacement of the first metatarsal head. The osteotomy is splinted by a K-wire passed medially to the phalanges and metatarsal head into the metatarsal diaphysis. During the period October 1999 to December 2001 this procedure was performed on 26 feet in 24 patients. Case notes were reviewed retrospectively to assess the subjective outcome following the operation. Patients were invited to attend a follow up clinic to assess the outcome using the Hallux Metatarsal-Interphalangeal Scale (HMIS) of the American Orthopaedic Foot and Ankle Society and weight bearing radiographs of the foot. Twelve patients (13 feet) were seen at this follow up. Discharge from hospital was on the day following surgery in 20/24 patients with three days maximum stay. K-wires and plaster boots were left in situ for 41 days on average (30–50 days range). From the case notes, using absence of hallux pain, deformity, hallux stiffness and footwear problems as outcome measures, 20 feet (77%) had a good outcome, five feet (19%) had a fair outcome and one foot (4%) had a poor outcome. At the follow up clinic at a mean time from operation of 134 weeks (range 56–153 weeks), the average HMIS score was 86/100 (Range 60–100) with 77% scoring 85 or more out of 100. Average postoperative intermetatarsal, hallux valgus and distal metatarsal articular angles were 6.9, 15.8 and 11 degrees respectively. Other than six cases of minor infection of skin, treated empirically with antibiotics, no other complications were seen. All patients were happy they had received this treatment. In conclusion the Kramer osteotomy is a technically simple operation which gives good results with few complications.
Abstract. Introduction. To investigate the impact medial opening wedge high tibial osteotomy (MOWHTO) has on the progression of patellofemoral OA, patella height and contact pressure within the patellofemoral joint (PF). Methods. A systematic review was conducted in January 2022 according to PRISMA guidelines. Each study was graded as per the MINORS criteria for non-randomised trials. The ICRS cartilage grade of the PF joint at the initial MOWHTO surgery and at second look surgery was compared and relative risk of progression of PF OA was calculated. Evaluation of patella height was assessed by Caton-Deschamps index, Blackburne-Peel index or Insall-Salvati ratio pre and post MOWHTO. Cadaveric studies assessing contact pressures in the PF after MOWHTO were included. Results. Forty-two studies comparing 2,419 patients were included. The mean age was 53.1 years (16–84), 61.3% female. The risk of progression of PF OA was highest in the uniplanar and biplanar MOWHTO with proximal tubercle osteotomy groups (RR= 1.28-1.51, I2= 0%), compared to biplanar MOHWTO with