Article

Hallux varus is a complication of hallux valgus surgery.
Historically the standard treatment has been to arthrodese the first
metatarso-phalangeal (MTP) joint. More recently other options have come to light,
including reverse osteotomies and tendon-transfer procedures. This
paper presents a small retrospective audit of patients who developed hallux varus
following the combined rotation scarf and Akin osteotomy for hallux valgus, and
their subsequent treatment with a stepwise approach of soft tissue release and
ultimately reverse scarf osteotomy and opening wedge osteotomy of the proximal
phalanx. METHOD: : Five patients attended for a retrospective audit including
reasons for revision surgery, review of intermetatarsal (IM) and first
metatarso-phalangeal joint (MTPA) angles, AOFAS scores and patient satisfaction.
RESULTS: : At a mean follow up of 38 months, mean IM angle and MTP joint angle
improved from 5 to 9 degrees and -10 degrees to 11 degrees respectively. Mean
first MTP joint dorsiflexion and plantarflexion was 26 degrees and 19 degrees
respectively. One patient was completely satisfied and four were satisfied with
reservations with their surgical outcome and 100% felt they were better off as a
result of their surgery. CONCLUSION: : The stepwise approach to the reverse scarf
and opening wedge osteotomy of the proximal phalanx for iatrogenic hallux varus
is an alternative to first MTP joint arthrodesis for those with a viable joint.
CI - Copyright (c) 2011 Elsevier Ltd. All rights reserved.

Langue : ANGLAIS