[The results of treatment of hallux valgus with subcapital osteotomy of the first metatarsal bone].

Michał Panasiuk, Paweł Woźniacki
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Abstract

This paper presents results of wedge subcapital osteotomy of the first metatarsal bone with lateral and plantar translation of the distal fragment in 47 feet (44 women age 37-72) operated for hallux valgus deformity. Bone fragments were stabilized with Kirschner wire introduced obliquely from lateral side of the head to the shaft. Protruding out of the skin part of the wire between I and II toe was shaped parallel to the lateral side of hallux preventing from valgisation. The mean AOFAS score improved from the preoperative value of 49 points to 86 points postoperatively. Hallux valgus angle improved from the mean preoperative value of 38 degrees to 17 degrees after operation. The mean postoperative AOFAS score in the group with major deformity (over 40 degrees valgity and 14 degrees intermetatarsal angle) was 76 points. Proposed method of stabilization allows limited activity without fear of correction loss during bone healing. Clinical and radiological results are similar to other authors' results, indicating that subcapital osteotomy gives satisfactory results in correction of medium grade deformity and disappointing results in severe deformities.

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第一跖骨下截骨术治疗拇外翻的疗效分析。
本文报道了47英尺(44名女性,年龄37-72岁)的第一跖骨楔骨下截骨术治疗拇外翻畸形的结果。用克氏针从头部外侧斜插入椎体固定骨碎片。I和II趾之间的金属丝从皮肤部分突出,与拇趾外侧平行,防止弯曲。平均AOFAS评分由术前的49分提高到术后的86分。拇外翻角由术前平均38度改善至术后17度。严重畸形组(畸形度大于40度,跖间角大于14度)术后平均AOFAS评分为76分。建议的稳定方法允许有限的活动,而不必担心在骨愈合过程中矫正损失。临床和影像学结果与其他作者的结果相似,表明capital下截骨术对中度畸形的矫正效果令人满意,对重度畸形的矫正效果令人失望。
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