Introduction. Recently, an increasing number of publications addressed the treatment of mild and moderate hallux valgus using corrective diaphyseal and distal osteotomies of the first metatarsal bone. Most of the diaphyseal and distal osteotomies of the first metatarsal bone are fixed with screws, which in combination with the shape of the bone saw cut provide, according to the authors, stability that is sufficient for early mobilization of patients, namely walking.
The objective of the study is a comparative analysis of the results of surgical treatment of patients with mild and moderate hallux valgus with the use of corrective proximal sphenoid osteotomy of the first metatarsal bone and Scarf osteotomy.
Materials and methods. The study is based on the surgical treatment of 100 patients with transverse-spread deformity of the forefoot and valgus deformation of the great toe of mild and moderate severity. Patients were divided into two groups, equal in number of people, gender (all women) and the average severity of the forefoot deformity. Patients of group 1 underwent corrective proximal sphenoid osteotomy (closing wedge) of the first metatarsal bone with fixation of “T”-shaped plate LCP of a single manufacturer. Patients of the group 2 underwent corrective Scarf osteotomy of the first metatarsal bone with fixation by two screws of a single manufacturer.
Results. The average score of the treatment result according to the Groulier scale in group 1 is higher (76.40 ± 0.83 points) than in group 2 (70.88 ± 1.45 points) (t 3.3; p<0.001). Among the complications after surgical treatment of transverse-spread deformation of the feet, the most common was recurrence of hallux valgus, reaching 28 % of cases in group 2, which is 22% higher than in group 1.
Conclusions. Displacement of the bone fragments of the first metatarsal bone in the osteotomy zone in the period of rehabilitation of the patients of group 2 resulted in 28% of cases of hallux valgus recurrence in the distant postoperative period, which is 22% higher than that in patients of group 1.
Keywords: hallux valgus, treatment, Scarf osteotomy, closing wedge osteotomy.
M1/M2 – the angle between the axes of the first and second metatarsal bones; M1/P1 – the angle of valgus deviation of the great toe; PASA – Proximal Articular Set Angle; HFMB – head of the first metatarsal bone; pre-op – before operation, post-op – after operation.
Address for correspondence:
Ruslan I. BUZNYTSKYI
Department of Traumatology and Orthopedics, Kharkiv Medical Academy of Postgraduate Education, Ukraine
Address: Amosova Street, 52, 133, Kharkiv, Ukraine 61176
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