DOI QR코드

DOI QR Code

Results of Modified Mau Osteotomy Fixed with Bioabsorbable Screws in Hallux Valgus

무지외반증에서 생체흡수성 나사못으로 고정한 변형 마우 절골술의 결과

  • Kim, Sanghwan (Department of Orthopedic Surgery, Daejeon Woori Hospital) ;
  • Yune, Young-Phil (Department of Orthopedic Surgery, Daejeon Woori Hospital)
  • 김상환 (대전우리병원 정형외과) ;
  • 윤영필 (대전우리병원 정형외과)
  • Received : 2015.02.27
  • Accepted : 2015.07.24
  • Published : 2015.09.15

Abstract

Purpose: The purpose of this study was to analyze the clinical results of application of bioabsorbable screws in hallux valgus surgery using modified Mau osteotomy. Materials and Methods: We retrospectively reviewed medical records of 25 patients. Operations were performed between May 2013 and January 2014. We performed 33 modified Mau osteotomies and fixed using bioabsorbable screws. Mean age of patients was 52 years (range 19 to 71). Mean follow up duration was 13.2 months (range 12.3 to 18.9). The clinical evaluations included pain visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and satisfaction score. Weight bearing anteroposterior radiographs were taken for measurement of hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA). All radiographs were evaluated in order to detect complications related to bioabsorbable screws such as osteolysis, cyst formation, and fixation failure. Results: The mean pre- and postoperative pain VAS scores were 4.0 and 1.7 (p<0.05). The mean AOFAS score improved from 52.6 to 82.8 (p<0.05). Preoperative HVA and IMA were 31.2 and 13.9, respectively. Postoperative HVA and IMA were 5.2 and 6.2 (p<0.05). The DMAA increased from 7.8 to 9.9 (p<0.05). There was one case of superficial wound infection and one loss of correction, and no case of osteolysis, cystic formation around the screw, or deep infection. All patients showed union without fixation failure. Conclusion: The clinical and radiological evaluation of this study demonstrates reliable results without fixation failure or allergic reaction. The use of bioabsorbable screw appears not to be inferior to metal screw fixation in hallux valgus surgery.

Keywords

References

  1. Mau C, Lauber HJ. Die operative Behandlung des Hallux valgus (Nachuntersuchungen). Deutsche Zeitschrift fur Chirurgie. 1926;197:361-77. https://doi.org/10.1007/BF02795221
  2. Bae SY, Kim YE. Modified mau osteotomy for the treatment of severe hallux valgus. J Korean Foot Ankle Soc. 2004;8:117-20.
  3. Robinson AH, Limbers JP. Modern concepts in the treatment of hallux valgus. J Bone Joint Surg Br. 2005;87:1038-45. https://doi.org/10.2106/JBJS.D.02060
  4. Stamatis ED, Navid DO, Parks BG, Myerson MS. Strength of fixation of Ludloff metatarsal osteotomy utilizing three different types of Kirschner wires: a biomechanical study. Foot Ankle Int. 2003;24:805-11. https://doi.org/10.1177/107110070302401014
  5. Unal AM, Baran O, Uzun B, Turan AC. Comparison of screwfixation stabilities of first metatarsal shaft osteotomies: a biomechanical study. Acta Orthop Traumatol Turc. 2010;44:70-5. https://doi.org/10.3944/AOTT.2010.2209
  6. Bostman OM. Absorbable implants for the fixation of fractures. J Bone Joint Surg Am. 1991;73:148-53. https://doi.org/10.2106/00004623-199173010-00022
  7. Gill LH, Martin DF, Coumas JM, Kiebzak GM. Fixation with bioabsorbable pins in chevron bunionectomy. J Bone Joint Surg Am. 1997;79:1510-8. https://doi.org/10.2106/00004623-199710000-00008
  8. Barber FA, Herbert MA, Coons DA, Boothby MH. Sutures and suture anchors--update 2006. Arthroscopy. 2006;22:1063.e1-9.
  9. Bostman OM, Pihlajamaki HK. Adverse tissue reactions to bioabsorbable fixation devices. Clin Orthop Relat Res. 2000; (371):216-27.
  10. Hirvensalo E, Bostman O, Tormala P, Vainionpaa S, Rokkanen P. Chevron osteotomy fixed with absorbable polyglycolide pins.Foot Ankle. 1991;11:212-8. https://doi.org/10.1177/107110079101100405
  11. Deorio JK, Ware AW. Single absorbable polydioxanone pin fixation for distal chevron bunion osteotomies. Foot Ankle Int. 2001;22:832-5. https://doi.org/10.1177/107110070102201010
  12. Small HN, Braly WG, Tullos HS. Fixation of the Chevron osteotomy utilizing absorbable polydioxanon pins. Foot Ankle Int. 1995;16:346-50. https://doi.org/10.1177/107110079501600606
  13. Winemaker MJ, Amendola A. Comparison of bioabsorbable pins and Kirschner wires in the fixation of chevron osteotomies for hallux valgus. Foot Ankle Int. 1996;17:623-8. https://doi.org/10.1177/107110079601701007