Mini TightRope System for Hallux Abducto Valgus Deformity

2010 ◽  
Vol 100 (4) ◽  
pp. 291-295 ◽  
Author(s):  
Bryan Christopher West
Keyword(s):  
Joint Stiffness ◽  
Metatarsophalangeal Joint ◽  
Valgus Deformity ◽  
Diabetic Woman ◽  
Cast Immobilization ◽  
First Metatarsophalangeal Joint ◽  
Joint Implant ◽  
Forefoot Surgery ◽  
History Of ◽  
Postoperative Deep Venous Thrombosis

This case report reviews the presentation and treatment of a 68-year-old diabetic woman with severe hallux abducto valgus deformity and progressively worsening pain and joint stiffness. The patient had a history of two distinct episodes of postoperative deep venous thrombosis and was deemed inappropriate for cast immobilization. The Arthrex Mini TightRope system was used in an attempt to reduce significantly increased intermetatarsal and hallux abductus angles, with the advantage of immediate postoperative weightbearing. An Integra K2 hemi-joint implant was also used to address the marked osteoarthritis at the first metatarsophalangeal joint. The potential role that this fixation technology may play in forefoot surgery is then discussed, along with its limitations and possible complications. (J Am Podiatr Med Assoc 100(4): 291–295, 2010)

Correlation analysis of the x-ray and functional parameters from the results of chevron (Austin) osteotomy for hallux valgus

2020 ◽  
pp. 54-63
Author(s):  
Ruslan Khairutdinov ◽  
Timur Minasov ◽  
Ekaterina Yakupova ◽  
Elvina Mukhametzyanova
Keyword(s):  
Hallux Valgus ◽  
Rating Scale ◽  
Metatarsophalangeal Joint ◽  
Valgus Deformity ◽  
First Metatarsophalangeal Joint ◽  
Chevron Osteotomy ◽  
Hallux Valgus Deformity ◽  
Valgus Angle ◽  
The Right ◽  
Bone Structures

Hallux valgus is characterized by the appearance and growth of a painful “lump” in the region of the first metatarsophalangeal joint, the development of forefoot corns, and inability to choose the right shoes, which leads to a significant decrease in the quality of life of these patients. Corrective osteotomies that preserve the metatarsophalangeal joint, for example Austin (Chevron) osteotomy, are usually used for hallux valgus deformity of the I, II degrees. Radiography with the study of the hallux valgus angle (HVA), the intermetatarsal angle (IMA), the distal metatarsal articular angle (DMAA) is a research method that shows the true correlation between bone structures. The correlation between the radiological and functional indicators of osteotomy allows us to determine possible recommendations for indications for surgical treatment of Hallux valgus. Correlation shows that the largest correction of hallux valgus in older patients occurs due to a small adjustment of the angle of DMMA and HVA. IMA had the best correction after Austin osteotomy among patients of a younger age, then the HVA, and the DMMA had minimum correction according to the AOFAS rating scale (Kitaoka). The revealed correlations allow us to determine the correct tactics for the treatment of hallux valgus by identifying the benefits of Austin osteotomy.

Follow-up of the Isolated Medial Approach to Hallux Abducto Valgus Correction Without Interspace Release

2002 ◽  
Vol 92 (10) ◽  
pp. 555-562 ◽  
Author(s):  
Jeffrey S. Boberg ◽  
Molly S. Judge
Keyword(s):  
Metatarsophalangeal Joint ◽  
Valgus Deformity ◽  
Study Group ◽  
Entire Study ◽  
First Metatarsophalangeal Joint ◽  
Intermetatarsal Angle ◽  
Medial Approach ◽  
Average Decrease ◽  
First Ray

A retrospective radiographic review was performed of 29 patients (37 feet) who underwent an isolated medial approach for correction of hallux abducto valgus deformity from March 1993 to November 1998. Only those patients who had a traditional Austin-type osteotomy with a reducible first metatarsophalangeal joint and flexible first ray were included in the study. The average follow-up period for the entire study group was 18.4 months, with 13 patients (44.83%; 17 feet) having a follow-up period of longer than 2 years. The average decrease in the intermetatarsal angle was 9.89°, and the average decrease in the hallux abductus angle was 14.0°, results that correlated well with those of other studies on correction of hallux abducto valgus. No clinical or radiographic recurrence of hallux abducto valgus was noted throughout the follow-up period. The authors believe that an isolated medial approach to hallux abducto valgus correction without a lateral interspace release yields predictable results when performed in appropriately selected patients. (J Am Podiatr Med Assoc 92(10): 555-562, 2002)

Forefoot Surgery in Rheumatoid Arthritis: Subjective Assessment of Outcome

Foot & Ankle ◽  
1987 ◽  
Vol 8 (3) ◽  
pp. 148-151 ◽  
Author(s):  
Lael G. Hasselo ◽  
Robert F. Willkens ◽  
Hugh E. Toomey ◽  
David E. Karges ◽  
Sigvard T. Hansen
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Severity ◽  
Metatarsophalangeal Joint ◽  
Severity Index ◽  
Subjective Assessment ◽  
Subjective Data ◽  
First Metatarsophalangeal Joint ◽  
Forefoot Surgery ◽  
First Ray ◽  
Better Than

Forefoot surgical outcomes were evaluated in 26 patients with rheumatoid arthritis. A total of 45 procedures were reviewed with emphasis on first ray intervention. Disease duration and aggressiveness of preceding medical therapy were combined to establish a disease severity index. Patients operated were predominantly in the midrange of disease severity. Subjective data on the relief of pain, callus, and deformity were favorable but this benefit was not long lasting inasmuch as patients were most satisfied in the period immediately following surgery and less so as time elapsed from intervention. Fusion of the first metatarsophalangeal joint seemed better than resection alone, indicating that stability should be the primary goal for surgical intervention of the rheumatoid forefoot.

The Simple Bunion: Anatomy at the Metatarsophalangeal Joint of the Great Toe

Foot & Ankle ◽  
1984 ◽  
Vol 4 (5) ◽  
pp. 229-240 ◽  
Author(s):  
Richard Alvarez ◽  
Ray J. Haddad ◽  
Nathaniel Gould ◽  
Saul Trevino
Keyword(s):  
Metatarsophalangeal Joint ◽  
Valgus Deformity ◽  
Metatarsal Osteotomy ◽  
Great Toe ◽  
First Metatarsophalangeal Joint ◽  
First Metatarsal ◽  
Hallux Valgus Deformity ◽  
Sesamoid Bones ◽  
Proper Interpretation

The pathomechanics for the development of the hallux valgus deformity takes place at the first metatarsophalangeal joint-the sesamoid complex. The sesamoid complex consists of seven muscles, eight ligaments, and two sesamoid bones. When the first metatarsal escapes the complex and drifts medially, the sesamoids remain twisted in situ, several of the ligaments “fail,” and others contract. The authors propose reduction of the metatarsus primus varus by first metatarsal osteotomy and appropriate ligament releases and plications to restore alignment. A detailed understanding of the pathomechanics is essential for proper interpretation of the problems and anticipated lasting surgeries.

scholarly journals Natural History of Radiographic First Metatarsophalangeal Joint Osteoarthritis: A Nineteen‐Year Population‐Based Cohort Study

2020 ◽  
Vol 72 (9) ◽  
pp. 1224-1230
Author(s):  
Catherine Bowen ◽  
Lucy Gates ◽  
Peter McQueen ◽  
Maxine Daniels ◽  
Antonella Delmestri ◽  
...  
Keyword(s):  
Cohort Study ◽  
Natural History ◽  
Metatarsophalangeal Joint ◽  
Population Based ◽  
First Metatarsophalangeal Joint ◽  
History Of

Clinical, Quantitative Assessment of First Tarsometatarsal Mobility in the Sagittal Plane and Its Relation to Hallux Valgus Deformity

1994 ◽  
Vol 15 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Kaj Klaue ◽  
Sigvard T. Hansen ◽  
Alain C. Masquelet
Keyword(s):  
Hallux Valgus ◽  
Sagittal Plane ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Valgus Deformity ◽  
Main Concern ◽  
First Metatarsophalangeal Joint ◽  
First Metatarsal ◽  
Hallux Valgus Deformity ◽  
First Ray

Today, bunion surgery is still controversial. Considering that a bunion deformity in fact may be a result of multiple causes, the rationale of the currently applied techniques of surgical treatment has not been conclusively demonstrated. In view of the known hypermobility syndrome of the first ray that results in insufficient weightbearing beneath the first metatarsal head, the relationship between this syndrome and hallux valgus deformity has been investigated. The results suggest a direct relationship between painful hallux valgus deformity and hypermobility in extension of the first tarsometatarsal joint. A pathological mechanism of symptomatic hallux valgus is proposed that relates this pathology with primary weightbearing disturbances in the forefoot where angulation of the first metatarsophalangeal joint is one of the consequences. The alignment of the metatarsal heads within the sagittal plane seems to be a main concern in many hallux valgus deformities. As a consequence, treatment includes reestablishing stable sagittal alignment in addition to the horizontal reposition of the metatarsal over the sesamoid complex. As an example, first tarsometatarsal reorientation arthrodesis regulates the elasticity of the multiarticular first ray within the sagittal plane and may be the treatment of choice in many hallux valgus deformities.

Biomechanical Risk Factors Associated with Neuropathic Ulceration of the Hallux in People with Diabetes Mellitus

2006 ◽  
Vol 96 (3) ◽  
pp. 189-197 ◽  
Author(s):  
Vanessa L. Nubé ◽  
Lynda Molyneaux ◽  
Dennis K. Yue
Keyword(s):  
Diabetes Mellitus ◽  
Subtalar Joint ◽  
Normal Values ◽  
Metatarsophalangeal Joint ◽  
First Metatarsophalangeal Joint ◽  
Factors Associated ◽  
Joint Range Of Motion ◽  
Foot Posture ◽  
History Of ◽  
Joint Range

In this study of people with diabetes mellitus and peripheral neuropathy, it was found that the feet of patients with a history of hallux ulceration were more pronated and less able to complete a single-leg heel rise compared with the feet of patients with a history of ulceration elsewhere on the foot. The range of active first metatarsophalangeal joint dorsiflexion was found to be significantly lower in the affected foot. Ankle dorsiflexion, subtalar joint range of motion, and angle of gait differed from normal values but were similar to those found in other studies involving diabetic subjects and were not important factors in the occurrence of hallux ulceration. These data indicate that a more pronated foot type is associated with hallux ulceration in diabetic feet. Further studies are required to evaluate the efficacy of footwear and orthoses in altering foot posture to manage hallux ulceration. (J Am Podiatr Med Assoc 96(3): 189–197, 2006)

Return to Activity after Sesamoidectomy in Athletically Active Individuals

2003 ◽  
Vol 24 (5) ◽  
pp. 415-419 ◽  
Author(s):  
Amol Saxena ◽  
Tom Krisdakumtorn
Keyword(s):  
Metatarsophalangeal Joint ◽  
Valgus Deformity ◽  
Return To Sports ◽  
Functional Importance ◽  
First Metatarsophalangeal Joint ◽  
Hallux Valgus Deformity ◽  
Incision Location ◽  
Active Patients ◽  
Return To Activity

Sesamoidectomy of the first metatarsophalangeal joint in athletically active patients may be indicated in cases of chronic sesamoiditis resistant to nonsurgical care or symptomatic displaced fractures or nonunion. Painful scar, hallux deviation, and delayed return to activity are all potential complications. These need to be considered especially when performing surgery in the athletically active individual. Twenty-six sesamoidectomies in 24 patients (21 females and 3 males) were reviewed for type of sesamoidectomy, incision location, time to return to activity, and complications. Mean age was 35.4 years (range, 16–68 years) with mean follow-up 86.4 months. Eleven athletes (defined as professional or varsity level sports) operated on had a mean return to activity of 7.5 weeks (range, 4–10 weeks), while 13 “active” patients had a mean return to activity of 12.0 weeks. This difference was statistically significant using the t-test, ( p <.02). There were 10 fibular and 16 tibial sesamoids excised. Complications included one hallux varus and two cases of postoperative scarring with neuroma-like symptoms, all associated with fibular sesamoidectomy; there was one case of hallux valgus deformity with tibial sesamoidectomy. Despite the functional importance of tibial and fibular sesamoids, athletically active individuals can return to sports after a sesamoidectomy as early as 7.5 weeks.

The Effect of Adductor Tendon Transposition in the Modified McBride Procedure

2008 ◽  
Vol 1 (5) ◽  
pp. 275-279 ◽  
Author(s):  
Alfonso Martínez-Nova ◽  
Raquel Sánchez-Rodríguez ◽  
Beatriz Gómez-Martín ◽  
Elena Escamilla Martínez ◽  
Antonio Expósito-Arcas ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Metatarsophalangeal Joint ◽  
Valgus Deformity ◽  
First Metatarsophalangeal Joint ◽  
Hallux Valgus Deformity ◽  
Radiographic Measurements ◽  
Group 2 ◽  
A Prospective Study ◽  
Adductor Hallucis ◽  
Group 1

The modified McBride technique is widely used in bunion surgery. The aim of this report is to analyze the influence that transferring the adductor hallucis tendon had on the first intermetatarsal angle (IMA), hallux abductus angle (HAA), and tibial sesamoid position (TSP) when used to correct the hallux valgus deformity. A prospective study was conducted of 31 hallux abducto valgus patients. A modified McBride procedure was performed to repair the deformity. In 16 patients (group 1), the adductor tendon was transferred, and in 15 (group 2), it was not. The tendon transfer was at random. The preoperative and postoperative variables IMA, HAA, and TSP were measured and analyzed by means of univariate and multivariate statistics. In group 1, the preoperative values of the first IMA and the HAA averaged 13.5° and 30°, respectively, decreasing postoperatively to 10.3° and 10.7°. In group 2, the corresponding preoperative angles were 12.9° and 25.6°, and the postoperative angles were 9.7° and 10°. There were no statistically significant differences between the 2 groups in the correction of the IMA, HAA, and TSP. As measured by the aforementioned radiographic measurements, there is no advantage in transferring the adductor hallucis tendon to the first metatarsophalangeal joint capsule in the correction of hallux valgus

Atypical Medial Dislocation of the First Metatarsophalangeal Joint

1998 ◽  
Vol 19 (9) ◽  
pp. 624-626 ◽  
Author(s):  
Leo Massari ◽  
Tommaso Ventre ◽  
Antonio lirillo
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Metatarsophalangeal Joint ◽  
Complete Recovery ◽  
Great Toe ◽  
Cast Immobilization ◽  
First Metatarsophalangeal Joint ◽  
Unusual Event ◽  
Vehicle Accident

Medial dislocation of the great toe without fracture or sesamoid separation is an unusual event. We are reporting such a case which occurred in a man after a motor vehicle accident. The patient was treated with closed reduction and cast immobilization. The patient recovered all his activities after 30 days. Three-year follow-up showed a complete recovery, clinically and radiographically, with only slight radiographic signs of osteoarthritis, which was present also in the contralateral foot.

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