Modified Simmonds-Menelaus procedure for moderate or severe adult hallux valgus

Yıl 2015, , 648 - 653, 28.10.2015

Yunus Emre Akman , Merter Yalcinkaya , Esra Circi Yunus Atici Yusuf Ozturkmen Ahmet Dogan

https://doi.org/10.3944/AOTT.2015.14.0289

Öz

Objective: The purpose of this study was to present the clinical and radiological results of modified Simmonds-Menelaus technique, performed as a proximal, medially-based, open-wedge osteotomy of the first metatarsal, in cases of moderate or severe adult hallux valgus deformity.
Methods: Fifty-one feet of 47 patients underwent surgery due to hallux valgus. Mean age was 41.2±14.0 years, and mean follow-up period was 99.5±36.0 months. Patients were evaluated with standing anteroposterior (AP) and lateral radiographies obtained in the preoperative and early postoperative periods, and during final follow-up. The parameters of hallux valgus angle (HVA), intermetatarsal angle (IA), metatarsal distal phalangeal angle (MDPA), and first metatarsal length (ML) were measured. For clinical evaluation, American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal (MTP-IP) scale was used.
Results: Mean preoperative HVA was 36.9°±7.3°, mean early postoperative HVA was 16.6°±6.2°, and mean final postoperative HVA was 28.9°±11.5°. Mean preoperative IA was 17.3°±4.5°, mean early postoperative IA was 8.8°±3.6°, and mean final postoperative IA was 14.3°±4.9°. Mean AOFAS hallux MTP-IP score was 71.9±20.1 at final follow-up.
Conclusion: From studies in the available literature, it is not clear whether the proximal open-wedge osteotomy technique itself is unsuccessful in adults or the lack of internal fixation led to failure. Application of an adequate fixation material should be used in order to avoid the collapse of the graft and to maintain the correction of the radiological parameters.

Anahtar Kelimeler

Distal soft tissue release, hallux valgus, modified Simmonds-Menelaus procedure, proximal osteotomy

Kaynakça

• Coughlin MJ, Mann RA, Saltzman CL. Surgery of the foot and ankle. Vol 1, 183–362, 8th edition, Mosby Else- vier, Philadelphia, 2007.
• Haınes Rw, Mcdougall A. The anatomy of hallux valgus. J Bone Joint Surg Br 1954;36–B:272–93.
• Mann RA, Coughlin MJ. Hallux valgus--etiology, anat- omy, treatment and surgical considerations. Clin Orthop Relat Res 1981;157:31–41.
• Ben-Ad R. Fixation updates for hallux valgus correction. Clin Podiatr Med Surg 2014;31:265–79.
• Canale T, Beaty J. Campbell’s Operative Orthopaedics. Chapter 78, Disorder of hallux, 4471–4563 11th edition, Mosby Elsevier, 2007.
• Sammarco GJ, Idusuyi OB. Complications after surgery of the hallux. Clin Orthop Relat Res 2001;391:59–71.
• Trethowan J. Hallux Valgus. In A System of Surgery, Ed. C.C. Choyce, New York P.B. Hoeber 1923. p. 1046–9.
• Simmonds FA, Menelaus MB. Hallux valgus in adoles- cents. J Bone joint surg 1960;42:761–68.
• Andreacchio A, Origo C, Rocca G. Early results of the modified Simmonds-Menelaus procedure for adolescent hallux valgus. J Pediatr Orthop 2002;22:375–9.
• Coughlin MJ. Hallux valgus. J Bone Joint Surg Am 1996;78:932–66.
• Okuda R, Kinoshita M, Yasuda T, Jotoku T, Shima H, Takamura M. Hallux valgus angle as a predictor of recur- rence following proximal metatarsal osteotomy. J Orthop Sci 2011;16:760–4.
• Sammarco VJ. Surgical correction of moderate and severe hallux valgus: proximal metatarsal osteotomy with distal soft-tissue correction and arthrodesis of the metatarso- phalangeal joint. Instr Course Lect 2008;57:415–28.
• Budny AM, Masadeh SB, Lyons MC 2nd, Frania SJ. The opening base wedge osteotomy and subsequent lengthen- ing of the first metatarsal: an in vitro study. J Foot Ankle Surg 2009;48:662–7.
• Ferrao PN, Saragas NP2. Rotational and opening wedge basal osteotomies. Foot Ankle Clin 2014;19:203–21.
• Badekas A, Georgiannos D, Lampridis V, Bisbinas I. Proximal opening wedge metatarsal osteotomy for correc- tion of moderate to severe hallux valgus deformity using a locking plate. Int Orthop 2013;37:1765–70.
• Nery C, Réssio C, de Azevedo Santa Cruz G, de Oliveira RS, Chertman C. Proximal opening-wedge osteotomy of the first metatarsal for moderate and severe hallux valgus using low profile plates. Foot Ankle Surg 2013;19:276– 82.
• Tóth K, Huszanyik I, Kellermann P, Boda K, Róde L. The effect of first ray shortening in the development of meta- tarsalgia in the second through fourth rays after metatarsal osteotomy. Foot Ankle Int 2007;28:61–3.