Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
권호 표지

Incomplete Reduction that Influence Reduction of Sesamoid as a Cause for Recurrence of Hallux Valgus

무지 외반증 재발의 한 원인으로 생각되는 종자골 정복에 영향을 주는 인자

  • Received : 2010.01.17
  • Accepted : 2010.05.13
  • Published : 2010.06.15
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The incomplete reduction of the sesamoid has lately been issued as cause for recurrence. In this study, we analysed factors that may influence reduction of sesamoid. Materials and Methods: The study consists of 50 cases operated by single surgeon. Eighteen cases were done by proximal chevron osteotomy, and 32 cases were done by scarf osteotomy. Hallux valgus (HV) angle and intermetatarsal (IM) angle were measured before and three months after the surgery. Sesamoid position (SP) was classified according to Hardy and Clapham grade system. Results: After the proximal chevron osteotomy, the correction of the mean HV angle was $19.5^{\circ}$, and IM angle was $6.2^{\circ}$. SP was changed from 5.6 to 3.4 grade. After the Scarf osteotomy, the correction of the mean HV angle was 25 degree, and IM angle was $9^{\circ}$. SP was changed from 5.5 to 2.8 grade. There was difference of sesamoid's correction between two different method of surgery (p=0.127). However, better correction of sesamoid was witnessed with bigger correction angle regardless of method of surgery (p=0.002, 0.001). Conclusion: We believe surgical method do not effect sesamoid's correction but more correction angle can result in better correction of sesamoid position.

Keywords

References

  1. Dreeben S, Mann RA. Advanced hallux valgus deformity: long-termresults utilizing the distal soft tissue procedure and proximal metatarsal osteotomy. Foot Ankle Int. 1996;17: 307-16. https://doi.org/10.1177/107110079601700603
  2. Mann RA, Rudicel S, Graves SC. Repair of hallux valgus with a distal soft-tissue procedure and proximal metatarsal osteotomy. J Bone Joint Surg Am. 1992;74:124-9.
  3. Veri JP, Pirani SP, CIaridge R. Crescentic proximal metatarsal osteotomy for moderateto severe hallux valgus:a mean 12.2 year follow-up study. Foot Ankle Int. 2001;22:817-22.
  4. Landis JR, Koch GG.The measurement of observer agreement for categorical data. Biometrics. 1977;33:159-71. https://doi.org/10.2307/2529310
  5. Sammarco GJ, ldusuyi OB. Complications after surgery of the hallux. Clin Orthop Relat Res. 2001;391:58-71.
  6. Scranton Jr PE, McDermott JE. Prognostic factors in bunion surgery. Foot Ankle Int. 1995;16:698-704. https://doi.org/10.1177/107110079501601105
  7. Okuda R, Kinoshita M, Yasuda T, Kitano N, Shima H. The shape of the lateral edge of the first metatarsal head as a risk factor for recurrence of hallux valgus. J Bone Joint Surg Am. 2007;89:2163-72. https://doi.org/10.2106/JBJS.F.01455
  8. Okuda R, Kinoshita M, Yasuda T, Kitano N, shima H, .lotoku T. Postoperative incomplete reduction of the sesamoids as a risk factor for recurrence of Hallux valgus. J Bone Joint surg Am. 2009;91:1637-45. https://doi.org/10.2106/JBJS.H.00796
  9. Helal B. The great toe sesamoid bones: the Ius or lost souls of Ushaia. Clin Orthop. 1981;157:82-7.
  10. lnge GAL, Ferguson AB.Surgery of the sesamoid bones of the great toe. Arch Surg. 1933;27:466-88. https://doi.org/10.1001/archsurg.1933.01170090041002
  11. Miller. JW.Distalfirst metatarsal displacement osteotomy: its place in theschemaofbunionsurgery. J Bone Joint Srug Am. 1974;56:923-31.
  12. Hardy RH, CIapham JC.Observation on hallux valgus; based on a controlled series. J Bone Joint Surg Br. 1951;33:376-91.
  13. Coughlin MJ. Hallux valgus. J Bone Joint Surg Am. 1996;78: 932-66.
  14. Wilson JD, Baines J,Siddique MS, Fleck R. The effect of sesamoid position on outcome following scarf osteotomy for hallux abducto valgus. Foot Ankle Surg. 2009;15:65-8. https://doi.org/10.1016/j.fas.2008.07.002
  15. Esemenli T,Yildirim Y, Bezer M. Lateral shifting of the first metatarsal head in hallux valgus surgery: effect on sesamoid reduction. Foot Ankle Int. 2003;24:922-6.