IATROGENIC HALLUX VARUS: CAUSES OF DEFORMITY AND POSSIBILITIES OF PERCUTANEOUS SURGICAL CORRECTION (RETROSPECTIVE ANALYSIS OF CASE REPORTS)

封面


如何引用文章

全文:

详细

Introduction. Hallux varus is a relatively rare foot deformity. Commonly, hallux varus is a complication after the hallux valgus surgery and typically is the result of the first metatarsal medial eminence over resection, first and second metatarsal excessive convergence, over release of the lateral soft tissues, overtightening of the medial soft tissues and soft tissue imbalance of the first metatarsophalangeal joint.

The purpose of this study was to clarify the causes and timing of the iatrogenic hallux varus formation and to evaluate the possibility and efficiency of percutaneous techniques in its surgical treatment.

Material and methods. Thirty-one feet (31 females suffering from iatrogenic hallux varus) were examined clinically and radiologically, including 14 patients who underwent surgery. The average age of the whole group was 57 years (range, 39 to 74), the subgroup of operated patients — 60 years (range from 53 to 68). The time after primary interventions before the examination varied from 2 to 44 years. The mean follow-up after surgery was 6 months (range from 1.5 to 54).

Results. No infection or wound-healing issues were observed. Overall, the patients were completely satisfied with the outcomes of 12 surgeries and satisfied with reservation in 2 cases.

Conclusions. The visual manifestations of hallux varus are determined not only by the hallux varus angle, but also by the value of the first intermetatarsal angle. In addition to well-known factors, hallux varus formation is determined by first metatarsal bone elongation and first metatarsophalangeal joint instability. In rare cases, only one of the factors leads to the hallux varus; as a rule, we see a combination of factors with their mutual reinforcement. Despite the demonstration of usage possibility and the efficiency of percutaneous techniques in hallux varus correcting, a small number of observations in the study does not yet allow giving recommendations on the use of specific percutaneous techniques depending on the various clinical manifestations of hallux varus.

作者简介

S. Berezhnoy

Medical center of the Main administration for services to the diplomatic corps (GlavUpDK) at the Ministry of Foreign Affairs of Russian Federation

编辑信件的主要联系方式.
Email: Doktor@Berezhnoi.ru

Sergey Yu. Berezhnoy — Dr. Sci. (Med.) Оrthopedic Surgeon.

2-y Botkinskiy proezd, 5, Moscow, 125284

俄罗斯联邦

参考

  1. Choi K.J., Lee H.S., Yoon Y.S., Park S.S., Kim J.S., Jeong J.J., Choi Y.R. Distal metatarsal osteotomy for hallux varus following surgery for hallux valgus. J Bone Joint Surg Br. 2011;93(8):1079-1083. doi: 10.1302/0301-620X.93B8.26430.
  2. Crawford M.D., Patel J., Giza E. Iatrogenic hallux varus treatment algorithm. Foot Ankle Clin. 2014;19(3): 371-384. doi: 10.1016/j.fcl.2014.06.004.
  3. Davies M.B., Blundell C.M. The treatment of iatrogenic hallux varus. Foot Ankle Clin. 2014;19(2):275-284. doi: 10.1016/j.fcl.2014.02.010.
  4. Hsu A.R., Gross C.E., Lin J.L. Bilateral hallux varus deformity correction with a suture button construct. Am J Orthop. 2013;42(3):121-124.
  5. Rochwerger A., Curvale G., Groulier P. Application of bone graft to the medial side of the first metatarsal head in the treatment of hallux varus. J Bone Joint Surg Am. 1999;81(12):1730-1735.
  6. Akhtar S., Malek S., Hariharan K. Hallux varus following scarf osteotomy. Foot (Edinb). 2016;29:1-5. doi: 10.1016/j.foot.2016.09.004.
  7. Kannegieter E., Kilmartin T.E. The combined reverse scarf and opening wedge osteotomy of the proximal phalanx for the treatment of iatrogenic hallux varus. Foot (Edinb). 2011;21(2):88-91. doi: 10.1016/j.foot.2011.01.011.
  8. Trnka H.J., Zettl R., Hungerford M., Mühlbauer M., Ritschl P. Acquired hallux varus and clinical tolerability. Foot Ankle Int. 1997;18(9):593-597. doi: 10.1177/107110079701800913.
  9. Машков В.М., Несенюк Е.Л., Безродная Н.В., Шахматенко И.Е. Коррекция варусной деформации первого пальца стопы, возникшей в результате хирургического лечения hallux valgus. Травматология и ортопедия России. 2010;1(55):21-27. Mashkov V.M., Nesenyuk E.L., Bezrodnaya N.V., Shakhmatenko I.E. [The correction of hallux varus deformity in consequence of surgical treatment for hallux valgus]. Travmatologiya i ortopediya Rossii [Traumatology and Orthopedics of Russia]. 2010;1(55): 21-27. (in Russian).
  10. Vanore J.V., Christensen J.C., Kravitz S.R., Schuberth J.M., Thomas J.L., Weil L.S., Zlotoff H.J., Couture S.D. Diagnosis and Treatment of First Metatarsophalangeal Joint Disorders. Section 3: Hallux Varus. J Foot & Ankle Surg. 2003;3(48):137-142.
  11. Donley B.G. Acquired Hallux Varus. Foot Ankle Int. 1997;18(9):586-592. doi: 10.1177/107110079701800911.
  12. Gradisek B.P., Weil L.Jr. Tendon transfers and salvaging options for hallux varus deformities. Clin Podiatr Med Surg. 2016;33(1):85-98. doi: 10.1016/j.cpm.2015.06.008.
  13. Бережной С.Ю. Артроз первого плюснефалангового сустава: чрескожное оперативное лечение, выбор хирургической методики, клинико-рентгенологическая классификация. Травматология и ортопедия России. 2017;1(23):8-22. (in Russian). doi: 10.21823/2311-2905-2017-23-1-8-22. Berezhnoy S.Yu. [First metatarsophalangeal joint osteoarthritis: percutaneous surgery, choice of a surgical procedure, clinical and radiographic classification]. Travmatologiya i ortopediya Rossii [Traumatology and Orthopedics of Russia]. 2017;1(23):8-22. (in Russian). doi: 10.21823/2311-2905-2017-23-1-8-22.
  14. Бережной С.Ю., Афанасьев Д.С. Двойная чрескожная остеотомия основной фаланги как способ устранения грубых вальгусных деформаций первого пальца стопы. Астраханский медицинский журнал. 2012;6(4):116-118. Berezhnoy S.Yu., Afanasyev D.S. [Double percutaneous proximal phalanx osteotomy as the way of correction of severe hallux valgus deformities]. Astrahanskiy meditcinskiy jurnal [Astrakhan Medical Journal]. 2012;6(4):116-118. (in Russian).
  15. Geaney L.E., Myerson M.S. Radiographic results after hallux metatarsophalangeal joint arthrodesis for hallux varus. Foot Ankle Int. 2015;36(4):391-394. doi: 10.1177/1071100714560400.
  16. Day M.H., Wickens E.H. Laetoli Pliocene hominid footprints and bipedalism. Nature. 1980;286:385-387. doi: 10.1038/286385a0.

补充文件

附件文件
动作
1. JATS XML
下载

版权所有 © ,


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 82474 от 10.12.2021.


##common.cookie##