[Hallux valgus: a therapy concept and its outcome from 1993 to 1996]

Abstract

Introduction: Aim of this study is to present the treatment concept and the results of hallux valgus surgery of our department.

Patients and methods: The criteria for decision making are 1st intermetatarsal angle, congruency of the first metatarsophalangeal joint and sesamoid position. According to our concept we performed between 1993 and 1996 42 Chevron osteotomies for mild, 138 Chevron with lateral soft tissue release (Chevron + LSR) for moderate and 93 basal crescentic (Mann) osteotomies with lateral soft tissue release for severe hallux valgus deformities.

Results: 31 Chevron, 118 Chevron with lateral soft tissue release and 80 basal crescentic osteotomies (Mann) were seen at an average follow up of 19 months (12-29) after a Chevron, respectively. 16 months (12-43) after Chevron with lateral soft tissue release and 18 months (12-32) after a basal crescentic osteotomy. 83% of all patients classified the results of the surgery as "very satisfactory" and "satisfactory". The average hallux valgus angle was corrected from preoperatively. 25.3 degrees (Chevron), 29.9 degrees (Chevron + LSR) and 41.8 degrees (Mann) to 16.5 degrees (Chevron), 12.1 degrees (Chevron + LSR) and 14.1 degrees (Mann) at final follow up, the average first intermetatarsal angle was corrected from preoperatively 12.1 degrees (Chevron), 14.0 degrees (Chevron + LSR) and 17.4 degrees (Mann) to 7.9 degrees (Chevron), 5.8 degrees (Chevron + LSR) and 7.8 degrees (Mann) at final follow up.

Conclusion: Our analysis of the three osteotomies revealed that with this differentiated concept we were able to achieve excellent and good results in more than 80% of our patients. Only with a treatment plan that includes different procedures to address the various stages of hallux valgus can one achieve the optimum result for the patient.