Distal Oblique Metatarsal Osteotomy for Hallux Valgus Deformity: A Clinical Analysis

J Foot Ankle Surg. 2017 May-Jun;56(3):497-504. doi: 10.1053/j.jfas.2017.01.018. Epub 2017 Feb 28.

Abstract

We compared the outcomes of the distal oblique metatarsal (DOM) osteotomy, which is parallel to the articulation surface of the proximal phalanx, with those of the chevron osteotomy and evaluated whether displacement and shortening of the first metatarsal have any effect on the incidence of metatarsalgia and patient satisfaction. Patients treated with the DOM osteotomy (n = 30) or distal chevron osteotomy (n = 31) were evaluated retrospectively. The chevron and DOM osteotomies both provided significant improvement in the first intermetatarsal angle (p < .001), hallux valgus angle (p < .001), distal metatarsal articular angle (p < .001), range of first metatarsophalangeal joint motion (p < .001), American Orthopaedic Foot and Ankle Society score (p < .001), and sesamoid position (p < .001), without any significant differences between the 2 groups. Patient satisfaction and metatarsalgia also were not different between the study groups. The DOM osteotomy group had higher plantar displacement (0.1 ± 0.1 mm versus 1.0 ± 0.1 mm; p < .001) and absolute shortening of the first metatarsal (1.0 ± 0.4 mm versus 6.8 ± 1.0 mm; p < .001). In conclusion, the DOM osteotomy is an alternative treatment method for mild and moderate hallux valgus.

Keywords: Wilson; chevron; distal osteotomy; hallux valgus; metatarsalgia.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Hallux Valgus / surgery*
  • Humans
  • Male
  • Metatarsal Bones / diagnostic imaging
  • Metatarsal Bones / surgery*
  • Metatarsophalangeal Joint / diagnostic imaging
  • Metatarsophalangeal Joint / physiopathology
  • Metatarsophalangeal Joint / surgery
  • Middle Aged
  • Osteotomy / methods*
  • Patient Satisfaction
  • Radiography
  • Range of Motion, Articular
  • Retrospective Studies
  • Young Adult