We reviewed the outcome of distal chevron metatarsal osteotomy without tendon transfer in 19 consecutive patients (19 feet) with a
Aims. Arthroplasty for end-stage
Aims. To examine the mid-term outcome and cost utility of the BioPro
metallic hemiarthroplasty for the treatment of
We studied 11 patients with checkrein deformities of the
Manipulation of the metatarsophalangeal joint and injection with steroid and local anaesthetic are widely practised in the treatment of
Over a period of one year we treated nine fractures of the sesamoid bones of the
The purpose of this study was to compare the
results of proximal and distal chevron osteotomy in patients with moderate
hallux valgus. We retrospectively reviewed 34 proximal chevron osteotomies without
lateral release (PCO group) and 33 distal chevron osteotomies (DCO
group) performed sequentially by a single surgeon. There were no
differences between the groups with regard to age, length of follow-up,
demographic or radiological parameters. The clinical results were
assessed using the American Orthopaedic Foot and Ankle Society (AOFAS)
scoring system and the radiological results were compared between
the groups. At a mean follow-up of 14.6 months (14 to 32) there were no significant
differences in the mean AOFAS scores between the DCO and PCO groups
(93.9 (82 to 100) and 91.8 (77 to 100), respectively; p = 0.176).
The mean hallux valgus angle, intermetatarsal angle and sesamoid
position were the same in both groups. The metatarsal declination
angle decreased significantly in the PCO group (p = 0.005) and the
mean shortening of the first metatarsal was significantly greater
in the DCO group (p <
0.001). We conclude that the clinical and radiological outcome after
a DCO is comparable with that after a PCO; longer follow-up would
be needed to assess the risk of avascular necrosis. Cite this article:
The mainstay of surgical correction of hallux valgus is first
metatarsal osteotomy, either proximally or distally. We present
a technique of combining a distal chevron osteotomy with a proximal
opening wedge osteotomy, for the correction of moderate to severe
hallux valgus. We reviewed 45 patients (49 feet) who had undergone double osteotomy.
Outcome was assessed using the American Orthopaedic Foot and Ankle
Society (AOFAS) and the Short Form (SF) -36 Health Survey scores.
Radiological measurements were undertaken to assess the correction. The mean age of the patients was 60.8 years (44.2 to 75.3). The
mean follow-up was 35.4 months (24 to 51).Aims
Patients and Methods
The aim of this study was to report a single surgeon series of
consecutive patients with moderate hallux valgus managed with a
percutaneous extra-articular reverse-L chevron (PERC) osteotomy. A total of 38 patients underwent 45 procedures. There were 35
women and three men. The mean age of the patients was 48 years (17
to 69). An additional percutaneous Akin osteotomy was performed
in 37 feet and percutaneous lateral capsular release was performed
in 22 feet. Clinical and radiological assessments included the type
of forefoot, range of movement, the American Orthopedic Foot and
Ankle (AOFAS) score, a subjective rating and radiological parameters. The mean follow-up was 59.1 months (45.9 to 75.2). No patients
were lost to follow-up.Aims
Patients and Methods
Metatarsus primus varus deformity correction
is one of the main objectives in hallux valgus surgery. A ‘syndesmosis’
procedure may be used to correct hallux valgus. An osteotomy is
not involved. The aim is to realign the first metatarsal using soft
tissues and a cerclage wire around the necks of the first and second
metatarsals. We have retrospectively assessed 27 patients (54 feet) using
the American Orthopaedic Foot and Ankle Society (AOFAS) score, radiographs
and measurements of the plantar pressures after bilateral syndesmosis
procedures. There were 26 women. The mean age of the patients was
46 years (18 to 70) and the mean follow-up was 26.4 months (24 to
33.4). Matched-pair comparisons of the AOFAS scores, the radiological
parameters and the plantar pressure measurements were conducted
pre- and post-operatively, with the mean of the left and right feet.
The mean AOFAS score improved from 62.8 to 94.4 points (p <
0.001).
Significant differences were found on all radiological parameters
(p <
0.001). The mean hallux valgus and first intermetatarsal
angles were reduced from 33.2° (24.3° to 49.8°) to 19.1° (10.1°
to 45.3°) (p <
0.001) and from 15.0° (10.2° to 18.6°) to 7.2°
(4.2° to 11.4°) (p <
0.001) respectively. The mean medial sesamoid
position changed from 6.3(4.5 to 7) to 3.6 (2 to 7) (p <
0.001)
according to the Hardy’s scale (0 to 7). The mean maximum force
and the force–time integral under the
Aims. Flexor hallucis longus (FHL) tendon transfer is a well-recognized
technique in the treatment of the neglected tendo Achillis (TA)
rupture. Patients and Methods. We report a retrospective review of 20/32 patients who had undergone
transtendinous FHL transfer between 2003 and 2011 for chronic TA
rupture. Their mean age at the time of surgery was 53 years (22
to 83). The mean time from rupture to surgery was seven months (1
to 36). The mean postoperative follow-up was 73 months (29 to 120).
Six patients experienced postoperative wound complications. Results. The mean postoperative Achilles tendon Total Rupture Score (ATRS)
was 83 (40 to 100) and the mean American Orthopaedic Foot &
Ankle Society (AOFAS) score was 94.3 (82 to 100). Tegner scoring
showed a mean reduction of one level from the pre-injury level of
activity. There was a mean reduction of 24% (4 to 54) in dynamometer-measured
strength of ankle plantarflexion, in comparison with the non-operated
side. The
Moderate to severe hallux valgus is conventionally
treated by proximal metatarsal osteotomy. Several recent studies
have shown that the indications for distal metatarsal osteotomy
with a distal soft-tissue procedure could be extended to include
moderate to severe hallux valgus. The purpose of this prospective randomised controlled trial was
to compare the outcome of proximal and distal Chevron osteotomy
in patients undergoing simultaneous bilateral correction of moderate
to severe hallux valgus. The original study cohort consisted of 50 female patients (100
feet). Of these, four (8 feet) were excluded for lack of adequate
follow-up, leaving 46 female patients (92 feet) in the study. The
mean age of the patients was 53.8 years (30.1 to 62.1) and the mean
duration of follow-up 40.2 months (24.1 to 80.5). After randomisation,
patients underwent a proximal Chevron osteotomy on one foot and
a distal Chevron osteotomy on the other. At follow-up, the American Orthopedic Foot and Ankle Society
(AOFAS)
We carried out a cross-sectional study in 51 patients (81 feet) with a clawed
Severe hallux valgus deformity is conventionally
treated with proximal metatarsal osteotomy. Distal metatarsal osteotomy
with an associated soft-tissue procedure can also be used in moderate
to severe deformity. We compared the clinical and radiological outcomes
of proximal and distal chevron osteotomy in severe hallux valgus deformity
with a soft-tissue release in both. A total of 110 consecutive female
patients (110 feet) were included in a prospective randomised controlled
study. A total of 56 patients underwent a proximal procedure and
54 a distal operation. The mean follow-up was 39 months (24 to 54)
in the proximal group and 38 months (24 to 52) in the distal group.
At follow-up the hallux valgus angle, intermetatarsal angle, distal
metatarsal articular angle, tibial sesamoid position, American Orthopaedic
Foot and Ankle Society (AOFAS)
The responsiveness of the Manchester–Oxford Foot
Questionnaire (MOXFQ) was compared with foot/ankle-specific and
generic outcome measures used to assess all surgery of the foot
and ankle. We recruited 671 consecutive adult patients awaiting
foot or ankle surgery, of whom 427 (63.6%) were female, with a mean
age of 52.8 years (18 to 89). They independently completed the MOXFQ,
Short-Form 36 (SF-36) and EuroQol (EQ-5D) questionnaires pre-operatively
and at a mean of nine months (3.8 to 14.4) post-operatively. Foot/ankle
surgeons assessed American Orthopaedic Foot and Ankle Society (AOFAS)
scores corresponding to four foot/ankle regions. A transition item measured
perceived changes in foot/ankle problems post-surgery. Of 628 eligible
patients proceeding to surgery, 491 (78%) completed questionnaires
and 262 (42%) received clinical assessments both pre- and post-operatively. The
regions receiving surgery were: multiple/whole foot in eight (1.3%),
ankle/hindfoot in 292 (46.5%), mid-foot in 21 (3.3%),
We report a systematic review and meta-analysis
of published randomised and quasi-randomised trials evaluating the
efficacy of pre-operative skin antisepsis and cleansing techniques
in reducing foot and ankle skin flora. The post-preparation culture
number (Post-PCN) was the primary outcome. The data were evaluated
using a modified version of the Cochrane Collaboration’s tool. We
identified eight trials (560 participants, 716 feet) that met the inclusion
criteria. There was a significant difference in the proportions
of Post-PCN between
The purpose of this study was to analyse the biomechanics of
walking, through the ground reaction forces (GRF) measured, after
first metatarsal osteotomy or metatarsophalangeal joint (MTP) arthrodesis. A total of 19 patients underwent a Scarf osteotomy (50.3 years,
standard deviation (Aims
Patients and Methods
Morton’s neuroma is common condition of the forefoot, but its
aetiology remains unclear. Our aim was to evaluate the relationship
between the width of the forefoot and the development of a Morton’s
neuroma. Between January 2013 and May 2016, a total of 84 consecutive
patients (17 men, 67 women) with a unilateral Morton’s neuroma were
enrolled into the study. The involved and uninvolved feet of each
patient were compared. A control group of patients with symptoms
from the foot, but without a neuroma who were matched for age, gender, affected
side, and web space location, were enrolled. The first to fifth
intermetatarsal distance, intermetatarsal angle and intermetatarsal
distance of involved web space on standing radiographs were assessed.Aims
Patients and Methods
Injuries to the foot in athletes are often subtle
and can lead to a substantial loss of function if not diagnosed
and treated appropriately. For these injuries in general, even after
a diagnosis is made, treatment options are controversial and become
even more so in high level athletes where limiting the time away
from training and competition is a significant consideration. In this review, we cover some of the common and important sporting
injuries affecting the foot including updates on their management
and outcomes. Cite this article: