Percutaneous hallux valgus correction using the Reverdin-Isham osteotomy - 07/06/10
Summary |
Introduction |
The present study assessed 2-year clinical and radiological results of percutaneous correction of hallux valgus by Reverdin-Isham osteotomy and sought to clarify indications for the technique.
Patient and methods |
A continuous prospective single-center series of 104 cases of medium-to-moderate hallux valgus was managed by the same percutaneous technique, with a median 2 years’ clinical and radiological follow-up (with no loss to follow-up). Uni- and multivariate analysis determined predictive factors for the mobility and degree of correction obtained.
Results |
American Orthopedic Foot and Ankle Society (AOFAS) functional score rose from a preoperative median of 49/100 to 87.5/100 postoperatively (p<0.05); 89% of patients were satisfied or very satisfied with their result at end of follow-up. Hallux valgus and distal metatarsal articular angle (DMAA) were significantly reduced (30 and 15° to 15 and 7°, respectively; p<0.05). Associated lateral ray surgery significantly increased the postoperative risk of MTP1 joint incongruence (p=0.009).
Discussion |
Percutaneous correction by Reverdin-Isham osteotomy seemed effective in isolated medium-to-moderate hallux valgus, but involves a learning curve and lacks precision in case of associated lateral metatarsal osteotomy, with a risk of DMAA hypercorrection and increased risk of MTP1 joint incongruence. Indications for percutaneous Reverdin-Isham osteotomy seem to be limited to isolated medium-to-moderate hallux valgus (M1M2 angle <15°, M1P1 angle around 30°) with elevated DMAA and congruent MTP1 joint.
Level of evidence |
Level IV. Therapeutic study.
Le texte complet de cet article est disponible en PDF.Keywords : Hallux valgus deformity, Percutaneous surgery, Metatarsal osteotomy, Reverdin-Isham osteotomy
Plan
Vol 96 - N° 4
P. 407-416 - juin 2010 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.