THE RECONSTRUCTIVE SURGICAL COMPLEX IN TREATMENT OF HALLUX VALGUS

Abstract

The article deals with clinical evaluation of effectiveness of unified technique of surgical correction of deformation of the first radius of foot - reconstructive surgical complex. During January 2010-January 2012, the surgical correction of valgus deformation of first toes was implemented in 86 patients (162 feet). The patients were aged from 18 to 70 years, mean age consisted 48 years. The female patients consisted 98% (n=85) and male patients - 2% (n=1). The mean duration of observation consisted 18 months (from 6 to 30 months). The evaluation of results and comparative analysis of treatment was made using the AOFAS score scale before operation and after 12 and 24 months after operation. In all cases, the operative intervention was applied because of halux valgus III. The reconstructive surgical complex included angular osteotomy and cuneiform resection in the basement of metatarsal bone I, intra-articular release and transosseous capsuloraffy of metatarsophalangeal joint I, cuneiform osteotomy of proximal phalanx of toe I according to Akin. The mean pre-operational angle consisted 47 degrees, M1M2 — 19 degrees, SL — 85%. At the moment of study mean value of HV consisted 15 degrees, M1M2 — 7 degrees, SL — 20%. The mean value according AOFAS scale consisted 86 scores before and 86 scores after the operation. In 8 weeks after the operation about 86% of patients were socially active, used the public transport and turned up for work. The reconstructive surgical complex is an effective technique of treatment of halux valgus III. The major advantage of the complex is in positive correction of varus deformation of metatarsal bone I and valgus deformation of toe I, stabilization of sesamoid gammak under head of metatarsal bone I, maintenance of movements in metatarsophalangeal joint I, shortening of period of medical social rehabilitation of patients.

Keywords

hallux valgus / halux valgus / reconstructive surgical complex / correction of foot radius I

References

[1] Диваков М.Г., Осочук В.С. // Остеотомия «SCARF» в лечении больных с вальгусной деформацией I пальца стопы. 2001; 3: 41—6.

[2] Истомина И.С., Кузьмин В.И., Левин А.Н. Оперативное лечение поперечного плоскостопия, Hallux Valgus. 2000; 1: 55—60.

[3] Кузьмин В.И. Теоретические и практические аспекты проектирования медицинских технологий качества лечения больных с деформациями стоп у взрослых: Автореф. дис.. д-ра мед. наук. М.; 2004.

[4] Coughlin K.J., Mann R.A. Hallux valgus. Surgery of the foot and Aakle 8th ed. St Louis: Mosby; 2007.

[5] Coetzee J. Scarf osteotomy for Hallux Valgus repair: The dark side. Foot Ankle Int. 2003; 24: 29—33.

[6] Larholt J., Kilmartin T.E. Rotational scarf and akin osteotomy for correction of Hallux Valgus associated with metatarsus adductus. Foot Ankle Int. 2010; 31 (3): 220—8.

[7] Kitaoka H., Alexander I., Adelaar R. et al. Clinical rating system for the avkle-hindfoot, midfoot, Hallux, and lesser toes. Foot Ankle Int. 1994; 15: 349—53.

[8] Taylor N.G., Metcalfe S.A. A review of surgical outcomes of the Lapidus procedure for treatment of hallux abductovalgus and degenerative joint disease of the first MCJ. The Foot. 2008; 18 (4): 206—10.

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