Surgical Treatment of Hallux Valgus with Application of External Fixation Device

Abstract

The experience in treatment of hallux valgus is presented. There were 90 patients, aged 19-77, 199 feet. Seven patients had first degree of deformity, 24 patients - second degree and 59 patients - third degree. Surgical treatment was performed in the period from 2004 to 2009. Depending on the deformity degree various types of osteotomy were applied followed by biomechanically stipulated fixation of bone fragments with small-sized rod and pin-rod external fixation devices. In all patients stable elimination of valgus deformity was achieved. Excellent long-term results were obtained in 67,5% of cases (112 feet), good results in 29,5% (45 feet) and satisfactory results in 3% (5 feet). Neither long-term failed results nor complications were observed. Advantages of surgical treatment of forefoot deformity with external fixation device are the restoration of foot anatomical shape and function in stable fixation of osteotomic fragments without limitations of active functional load on the operated foot.

Keywords

hallux valgus / radiologic diagnosis / osteotomy of first metatarsal bone / small-sized external fixation devices

References

[1] Богданов Ф.Р. Хирургическое лечение повреждений и заболеваний стопы. - М., 1953.

[2] Гохаева А.Н. Метод чрескостного остеосинтеза в лечении hallux valgus третьей степени //Гений ортопедии. - 2008. - N 3. - С. 91-94.

[3] Истомина И.С., Кузьмин В.И., Левин А.Н. Оперативное лечение поперечного плоскостопия, hallux valgus //Вестн. травматол. ортопед. - 2000. - N 1. - С. 55-60.

[4] Крамаренко Г.Н. Статические деформации стоп //Современные методы лечения контрактур и деформаций суставов. - М., 1975. - С. 69-90.

[5] Попов А.В., Зоря В.И. Современная система оперативной коррекции поперечно-распластанной стопы с вальгусным отклонением первого пальца //Травматол. ортопед. России. - 2000. - N 2-3. - С. 55-59.

[6] Травматология и ортопедия: Руководство для врачей /Под ред. Ю.Г. Шапошникова. - М., 1997. - Т. 3.

[7] Циркунова Н.А. Плантография как метод диагностики плоскостопия //Материалы 3-го Пленума межвед. комиссии по рациональной обуви. - М., 1968. - С. 45-46.

[8] Черкес-Заде Д.И., Каменев Ю.Ф. Хирургия стопы. - 2-е. изд. - М., 2002.

[9] Шевцов В.И., Исмайлов Г.Р. Чрескостный остеосинтез в хирургии стопы. - М., 2008.

[10] Яременко Д.А. Диагностика и классификация статических деформаций стоп //Ортопед. травматол. - 1985. - N 11. - С. 59-67.

[11] Carret J.P., Ferriera A. Biomecanique du pied. Pathologie osteo-articulaire du pied et de la cheville. - 2nd ed. - Springer, 2000. - P. 16-24.

[12] Coughlin M.J., Shurnas P.S. Hallux rigidus: demo-graphics, etiology, and radiographic assessment //Foot Ankle Int. - 2003. - Vol. 24, N 10. - P. 731-743.

[13] Coughlin M.J., Jones C.P. Hallux valgus: demographics, etiology, and radiographic assessment //Foot Ankle Int. - 2007. - Vol. 28, N 7. - P. 759-777.

[14] Dittrich R. Uber die Entstehungsursache des H. V. //Arch. Orthop. Unfallchir. - 1922. - Bd 21, H. 1. - S. 321-326.

[15] Hunsaker F.G. et al. The American Academy of Orthopaedic Surgeons outcomes instruments: normative values from the general population //J. Bone Jt Surg. - 2002. - Vol. 84A, N 2. - P. 208-215.

[16] Gumpert N., Jungermann M. Die optimale Therapie des Hallux Valgus, Letzte Aktualisierung. - Springer, 2009.

[17] Inman V.T. Hallux valgus: a review of etiological factors //Ortop. Clin. North Am. - 1974. - N 5. - P. 59-66.

[18] Kaz A.J., Coughlin M.J. Crossover second toe: demographics, etiology, and radiographic assessment //Foot Ankle Int. - 2007. - N 12. - P. 1223-1237.

[19] Menz H.B., Morris M.E. Footwear characteristics and foot problems in older people //Gerontology. - 2005. - Vol. 51, N 5. - P. 346-351.

[20] Menz H.B. et al. Predictors of podiatry utilisation in Australia: the North West Adelaide Health Study //J. Foot Ankle Res. - 2008. - Vol. 1, N 1. - P. 8.

[21] Roddy E., Zhang W., Doherty M. Prevalence and associations of hallux valgus in a primary care population //Arthritis Rheum. - 2008. - Vol. 59, N 6. - P. 857-862.

RIGHTS & PERMISSIONS

Eco-Vector