The Modified Subcapital Metatarsal Osteotomy in the Treatment of Hallux Valgus Recurrence

Foot Ankle Spec. 2020 Oct;13(5):404-414. doi: 10.1177/1938640019875322. Epub 2019 Oct 4.

Abstract

The purpose of the present study is to illustrate the use of a modified subcapital metatarsal osteotomy (MSMO) in the treatment of hallux valgus (HV) recurrence. The article reports the clinical and radiological outcomes of a cohort of 52 consecutive patients presenting with recurrent HV, treated with MSMO. A total of 52 patients (54 feet) underwent operations between May 2010 and November 2015. The mean time of follow-up was 2.5 years (range 5.5-1.0 years), and the mean age was 49 years (range 22-76 years). The patient cohort comprised 46 female and 6 male patients. The results of this research show that MSMO is a reliable technique for the correction of HV recurrence. The postoperative radiographic assessments show a statistically significant postoperative improvement of the HV angle (P < .05) and the intermetatarsal angle (P < .05). The postoperative position of the tibial sesamoid was significantly improved (P < .1). The distal metatarsal articular angle was improved (P < .001), though assessment may be affected by the previous operations performed on the first metatarsophalangeal joint. The statistical analysis shows that the postoperative American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal Scale parameters were significantly improved (P < 0.001). Results of this study indicate that the minimally invasive MSMO is effective in restoring anatomical alignment and improving patient outcomes in recurrent cases of HV.Levels of Evidence: Level III: Case-control study.

Keywords: distal first metatarsal osteotomy; foot surgery; hallux valgus; metatarsalgia; osteosynthesis.

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Hallux Valgus / diagnostic imaging
  • Hallux Valgus / surgery*
  • Humans
  • Male
  • Metatarsal Bones / diagnostic imaging
  • Metatarsal Bones / surgery*
  • Middle Aged
  • Osteotomy / methods*
  • Radiography
  • Recurrence
  • Treatment Outcome
  • Young Adult