AIM

To present our experience in patients treated under primary diagnosis giant cell tumor of bone at Department Orthopaedic Surgery Zagreb University School of Medicine in a 15-year period from 1995 to 2009.

Aims: The aim of the study is to present later results in the treatment of hallux valgus with Austin corrective metatarsal osteotomy.

Materials and methods: In the period from 1982 to 1991, 238 patients (230 females and 8 males) and 380 feet were operated. The patients were followed up from 11 to 20 years. The age of the patients varied from 40 up to 60 years (the median value of around 46 years of age). Indications for the Austin corrective metatarsal osteotomy were the angle of hallux valgus more than 20 degrees, intermetatarsal angle more than 10 degrees as well as pain due to shoe pressure over the medial side of metatarsophalangeal joint and aesthetic reasons. In this study, 130 patients and 230 feet were evaluated (radiological, clinical and subjective evaluation).

Results: The angle of hallux valgus was 20 to 52 degrees (mean value – 34.5 degrees) before operation, and 8 to 36 degrees after operation (mean value – 16.1 degrees). Intermetatarsal angle was 10 to 25 (mean value – 15 degrees) before operation and 7 to 22 degrees (mean value – 8 degrees) after operation. Shortening of first metatarsal bone was 2 to 6 mm (mean value – 3 mm)

Conclusion: The study shows that Austin corrective metatarsal osteotomy in treatment of hallux valgus is a good method if strict and precise criteria are closely followed in the indication of operative procedure in treating hallux valgus, especially with middle-aged patients.

Aims: The aim of the study is to present early results in the treatment of hallux valgus with a new 3D subcapital metatarsal osteotomy, based on a original Wilson osteotomy. 3D subcapital metatarsal osteotomy is a simple and fast procedure where we shift capitis of metatarsal bone to lateral and plantar, and fix with K-wire.

Materials and methods: In the period from 1997 to 2003, 25 patients (all females) and 34 feet were operated. The patients were followed up from 1 to 7 years. The age of the patients varied from 33 up to 60 years (median value – 45 years of age). Indications for the corrective metatarsal osteotomy were the angle of hallux valgus more than 20 degrees, intermetatarsal angle more than 20 degrees as well as pain due to shoe pressure over the medial side of metatarsophalangeal joint, and aesthetic reasons. In this study all feet were evaluated (radiological, clinical and subjective evaluation).

Results: The angle of hallux valgus was 20 to 50 degrees (mean value – 32.3 degrees) preoperatively, and dropped to 2 to 35 (mean value – 12.47 degrees) postoperatively. Intermetatarsal angle was 10 to 22 (mean value – 15 degrees) before operation, and 3 to 15 degrees (mean value 5 degrees) after operation. The DMA angle was 0 to 30 (mean value – 15 degrees) before operation, and 0 to 20 degrees (mean value – 20 degrees) afterwards. Shortening of first metatarsal bone was 1 to 8 mm (mean – 3 mm). We did not have any complications.

Conclusion: Early results of this study show that new 3D subcapital metatarsal osteotomy in treatment of hallux valgus is a good method. It is necessary to follow strict and precise criteria in the indication of operative procedure in treating hallux valgus. The procedure itself is simple and fast.