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Beitragstitel Simultaneous Bilateral Isolated Hallux Valgus Correction Using A New Distal Metatarsal Osteotomy: Clinical, Radiological And Pedobarographic Evaluation With A Minimum Of Two Years Follow Up.
Beitragscode P46
  1. Amadou Cissé Hirslanden Lausanne Vortragender
  2. Patrick Vienne Clinique du Pied/Hirslanden/Bois-Cerf/Medicol
  3. Brigitte Jolles-Haeberli CHUV & Université de Lausanne
Präsentationsform Poster
  • A06 - Fuss
Abstract Background
Hallux valgus is the most common forefoot deformity whose incidence is bilateral in 84 to 97.3% of cases. This raises the question on whether these cases should be operated sequentially or simultaneously.

We wish to examine the pertinence of simultaneous bilateral HV correction in the treatment of moderate to severe isolated bilateral symptomatic hallux valgus deformity.

Study Design & Methods
Between 2015 and 2018, we performed 341 hallux valgus corrections using the ReveL procedure, a new distal biplanar metatarsal osteotomy technique, completed by the Akins osteotomy in necessary cases. Of these, 31 cases with simultaneous correction of an isolated bilateral HV deformity were selected. The AOFAS and the EQ-5D scores were used to evaluate the clinical outcome. HV, IMA and DMAA angles as well as sesamoid deviation were compared in pre- and postoperative standard standing X-rays. Gait analysis was performed at longest follow-up and Max-F, Peak-P, Con-A, Con-T and FTI values were compared the ones of a sex and age matched group of healthy subjects.

At last follow-up, we observed significant rise in AOFAS score by an average of 35 points. We observed average reduction of the following radiological parameters: HV angle by 19.37°, IMA by 8.21°, DMAA by 17.67° and sesamoid deviation by 3.4mm. There was no significant difference between the gait analysis of the control group and the forefoot plantar pressure was restored and similar to healthy subjects.

We concluded that simultaneous osteotomies in bilateral cases of moderate-to-severe HV improves patient’s clinical and radiological outcome, with a high level of satisfaction.