[Clinical pedographic radiological findings after basal valgus osteotomy of metatarsal 1--a prospective study]

Abstract

Aim: This study investigated the influence of valgusizing base wedge osteotomy of metatarsal 1 (MT 1) subsequently on the entire forefoot.

Method: Pre- and post-operatively 22 cases were investigated between 1998 and 2000 both clinically and radiologically with pedographic analysis in 20 of these cases.

Results: According to the Kitaoka Score we could establish preoperative 37 and postoperative 72 out of 100 possible points. Following the MT 1-base wedge osteotomy with a distal soft-tissue procedure, the central forefoot region (MT 2/3) showed reduced pressure-induced pain, unchanged callus development, and reduced maximum load pressure. When the Plus-Index (MT 1 longer than MT 2) could be preserved in the valugusizing MT 1-base wege osteotomy, the metatarsalgia in the central forefoot region not only improved generally, but also the maximum loading pressure was clearly reduced. In cases with a post-operative Minus-Index (MT 1 shorter than MT 2), as well as in those Plus-Index cases undergoing a Keller procedure in the valgusizing base wedge osteotomy, the elevated pressure values in the central forefoot region persisted.

Conclusion: In valgusizing MT 1-base wege osteotomy with preservation of the Plus-Index (MT 1 longer MT 2), metatarsalgia can be improved and the maximum loading pressure in the central forefoot can be reduced.