Correction of Hallux Abducto Valgus Deformity Using Closing Base Wedge Osteotomy: A Study of 101 Patients

J Foot Ankle Surg. 2020 Sep-Oct;59(5):979-983. doi: 10.1053/j.jfas.2020.04.007. Epub 2020 Jul 1.

Abstract

Hallux abducto valgus is a functionally disabling deformity with lateral deviation of the hallux and medial prominence of the first metatarsal head. Various surgical techniques have been used in the treatment of this deformity. In this retrospective review, we assess the outcomes of proximal closing base wedge osteotomy (CBWO). A single-surgeon database was reviewed for patients who underwent proximal CBWO between January 1, 2012, and December 31, 2017. A total of 101 patients were identified with a mean age of 49 years (range 13 to 80) and mean body mass index of 29 kg/m2 (range 19 to 53). The medical records were reviewed for smoking status, time to heal, rates of nonunion, shortening of the first metatarsal, intermetatarsal angle, hallux valgus angle, elevatus, mean loss of correction, complication rates, and pain scores. Pre- and postoperative variables were compared using Student's t test for continuous variables. The mean pre- and postoperative intermetatarsal angles were 15.46° (range 10° to 21°) and 3.77° (range 0° to 10°; p < .05). The mean pre- and postoperative hallux abductus valgus angles were 34.57° (range 12° to 60°) and 9.24° (range, 0° to 30°;p < .05). The mean metatarsal length shortening was 3.72 mm, and the mean postoperative elevatus was 2.73 mm. We have demonstrated excellent outcomes of CBWO with correction of intermetatarsal and hallux valgus angles. This procedure allows for superior reduction of moderate to severe intermetatarsal angles in rigid first rays. The mean postoperative elevatus of 2.73 did not result in any adverse sequelae.

Keywords: bunion; elevatus; first metatarsal; intermetatarsal angle; proximal first metatarsal osteotomy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Hallux Valgus* / diagnostic imaging
  • Hallux Valgus* / surgery
  • Hallux*
  • Humans
  • Metatarsal Bones* / diagnostic imaging
  • Metatarsal Bones* / surgery
  • Middle Aged
  • Osteotomy
  • Radiography
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult