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Reinhard Schuh - One of the best experts on this subject based on the ideXlab platform.
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correction power and complications of first tarsometatarsal joint arthrodesis for hallux Valgus Deformity
International Orthopaedics, 2015Co-Authors: Madeleine Willegger, Johannes Holinka, Robin Ristl, Reinhard Windhager, Axel Wanivenhaus, Reinhard SchuhAbstract:Purpose First tarsometatarsal joint (TMTJ) arthrodesis is known as a powerful operative procedure to correct moderate to severe hallux Valgus Deformity. However, there is little evidence about actual complication rates and angular correctional power. The aims of the present study were to evaluate the (1) angular correction power and (2) complication rates of pooled data for this procedure and to perform subgroup analysis of different methods of fixation.
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angular correction and complications of proximal first metatarsal osteotomies for hallux Valgus Deformity
International Orthopaedics, 2013Co-Authors: Reinhard Schuh, Madeleine Willegger, Johannes Holinka, Robin Ristl, Reinhard Windhager, Axel WanivenhausAbstract:Purpose Proximal first metatarsal osteotomies are recommended for the surgical treatment of moderate to severe hallux Valgus Deformity. This study aimed to compare correction of intermetatarsal and hallux Valgus angles and complications of proximal crescentic, Ludloff, proximal opening wedge, proximal closing wedge, proximal chevron and other proximal first metatarsal osteotomies.
Mark E. Easley - One of the best experts on this subject based on the ideXlab platform.
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Outcomes of Total Ankle Arthroplasty in Moderate and Severe Valgus Deformity.
Foot & ankle specialist, 2018Co-Authors: Constantine A. Demetracopoulos, Elizabeth A. Cody, Samuel B. Adams, James K. Deorio, James A. Nunley, Mark E. EasleyAbstract:Introduction. Failure to correct coronal Deformity at the time of total ankle arthroplasty (TAA) can lead to early implant failure. We aimed to determine clinical, radiographic, and patient-reported outcomes of patients with moderate to severe Valgus Deformity who underwent TAA for end-stage ankle arthritis. Methods. Patients with a Valgus Deformity of at least 10° who underwent TAA were retrospectively reviewed. The coronal tibiotalar angle was assessed on radiographs preoperatively, at 1 year, and at final follow-up. The visual analog scale (VAS) for pain, Short Form-36 (SF-36), American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot-ankle scale, and Short Musculoskeletal Function Assessment (SMFA) scores were assessed preoperatively and at final follow-up. Results. Mean preoperative Valgus Deformity was 15.5 ± 5.0°, and was corrected to a mean of 1.2 ± 2.6° of Valgus postoperatively. VAS, SF-36, AOFAS, and SMFA scores improved significantly (P < .001 for all). There was no significant change in tibiotalar angle between 1 year and final follow-up in either group. Reoperation and revision rates did not differ between groups. Conclusion. Correction of coronal alignment was achieved and maintained in patients with both moderate and severe preoperative Valgus malalignment. Outcome scores significantly improved for all patients. Levels of Evidence: Therapeutic, Level IV.
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moderate to severe hallux Valgus Deformity correction with proximal crescentic osteotomy and distal soft tissue release
Archives of Orthopaedic and Trauma Surgery, 2000Co-Authors: R Zettl, Mark E. Easley, Hansjorg Trnka, M Salzer, Peter RitschlAbstract:Between 1991 and 1995, 96 patients (114 feet) were treated with a proximal crescentic metatarsal osteotomy and distal soft-tissue procedure for moderate to severe hallux Valgus Deformity [intermetatarsal (IM) angle > 15°, or hallux Valgus (HV) angle > 30°]. At an average follow-up of 26 months, 8 men and 62 women (86 feet) with a mean age of 53.2 years were retrospectively reviewed. The HV angle averaged 41.1° preoperatively and 14.6° postoperatively. The respective values for the IM angle were 17.8° and 7.8°. Neither the average metatarsal shortening of 3 mm nor the dorsal angulation at the osteotomy site seen in 9% of cases evidenced any clinical significance at follow-up. Patient satisfaction was excellent or good in 91%, and the mean Mayo Clinic Forefoot Score (total 75 points) improved from 37.2 to 61.1 points. Complications included 8 cases of hallux varus and 5 cases of hardware failure. Based on this first study exclusively focusing on moderate to severe hallux Valgus Deformity, we conclude that proximal first metatarsal osteotomy in combination with a lateral soft-tissue procedure is effective in correcting moderate to severe symptomatic hallux Valgus Deformity with metatarsus primus varus (IM angle > 15° or HV angle > 30 °).
Sherif N. G. Bishay - One of the best experts on this subject based on the ideXlab platform.
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Great toe metatarsophalangeal arthrodesis for hallux Valgus Deformity in ambulatory adolescents with spastic cerebral palsy
Journal of Children's Orthopaedics, 2009Co-Authors: Sherif N. G. Bishay, Mustafa H. El-sherbini, Ashraf A. Lotfy, Hatem M. Abdel-rahman, Hany N. Iskandar, Mohsen M. El-sayedAbstract:Background Hallux Valgus Deformity is a common sequel of spastic cerebral palsy. Methods Twenty ambulatory patients (24 feet) suffering hallux Valgus Deformity, with painful forefoot and restricted footwear, secondary to spastic cerebral palsy acquired perinatally, were treated with great toe metatarsophalangeal (MTP) arthrodesis using percutaneous K-wires for fixation. The mean age at the time of surgery was 16.2 years (range 14–18 years). They were retrospectively evaluated for the results after arthrodesis at a mean interval of 3 years and 4 months (range 3–4 years) by physical examination and radiographs. Results All patients had a stable painless aligned great toe, with
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great toe metatarsophalangeal arthrodesis for hallux Valgus Deformity in ambulatory adolescents with spastic cerebral palsy
Journal of Children's Orthopaedics, 2009Co-Authors: Sherif N. G. Bishay, Ashraf A. Lotfy, Hany N. Iskandar, Mustafa H Elsherbini, Hatem M Abdelrahman, Mohsen Mohammad ElsayedAbstract:Abstract Background Hallux Valgus Deformity is a common sequel of spastic cerebral palsy. Methods Twenty ambulatory patients (24 feet) suffering hallux Valgus Deformity, with painful forefoot and restricted footwear, secondary to spastic cerebral palsy acquired perinatally, were treated with great toe metatarsophalangeal (MTP) arthrodesis using percutaneous K-wires for fixation. The mean age at the time of surgery was 16.2 years (range 14–18 years). They were retrospectively evaluated for the results after arthrodesis at a mean interval of 3 years and 4 months (range 3–4 years) by physical examination and radiographs. Results All patients had a stable painless aligned great toe, with <10° Valgus, <20° dorsiflexion and neutral rotation after arthrodesis, evidenced by improvement in pain, cosmesis, functional activity, footwear, callosities and hygiene, as well as by significant improvement in the measures of the MTP and the intermetatarsal angles (IMA) by postoperative radiographs. Neither non-union (pseud...
Tun Hing Lui - One of the best experts on this subject based on the ideXlab platform.
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Correction of Recurred Hallux Valgus Deformity by Endoscopic Distal Soft Tissue Procedure.
Arthroscopy techniques, 2017Co-Authors: Tun Hing LuiAbstract:Abstract The underlying reason for recurrence of hallux Valgus Deformity after bunion surgery is multifactorial and includes surgeon-based and patient-based factors as well as original components of Deformity initially unaddressed at the index procedure. Surgical treatment of a recurred hallux Valgus Deformity should be undertaken using the same guidelines for correction of a primary hallux Valgus Deformity. It requires correction of bony alignment, restoration of joint congruity, and achievement of soft tissue balance. The purpose of this Technical Note is to describe the details of endoscopic soft tissue procedure to correct a recurred hallux Valgus Deformity. To successfully complete this procedure, adequate lateral release to achieve soft tissue balance around the first metatarsophalangeal joint with reduction of the sesamoid bones is mandatory.
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Endoscopic-assisted Correction of Hallux Valgus Deformity.
Sports medicine and arthroscopy review, 2016Co-Authors: Tun Hing Lui, Samuel K.k. Ling, Simon Chi Pan YuenAbstract:Endoscopic distal soft-tissue procedure is one of the minimally invasive techniques for correction of the hallux Valgus Deformity. It employs the same principle as the open procedure. The intermetatarsal angle is corrected by screw and interosseous suture instead of first metatarsal osteotomy. The associated procedures of first metatarsal derotation, medial collateral ligament reconstruction, and arthroscopic Lapidus arthrodesis can tackle various problems faced during the endoscopic distal soft-tissue procedure.
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Technical tip: Reconstruction of medial collateral ligament in correction of hallux Valgus Deformity with primary medial collateral ligamentous insufficiency
Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons, 2011Co-Authors: Tun Hing Lui, Kwok Bill ChanAbstract:In cases of hallux Valgus Deformity with primary medial collateral ligamentous insufficiency, there will be an abnormal hallux Valgus angle with relatively normal intermetatarsal angle and sesamoid positions. Metatarsal osteotomies may not be effective to correct the Deformity. Plication of the attenuated medial capsule may not be strong enough to provide long lasting correction of the hallux Valgus Deformity. We describe a minimally invasive technique of reconstruction of the medial collateral ligament by means of extensor hallucis brevis tendon graft. This can provide a stronger medial constraint to prevent recurrence of hallux Valgus Deformity.
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Arthroscopy-assisted correction of hallux Valgus Deformity.
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the Internation, 2008Co-Authors: Tun Hing Lui, Kwok Bill Chan, Hung Tsan Chow, Chun Man, Ping Keung Chan, Wai Kit NgaiAbstract:Purpose: Our purpose was to evaluate the clinical and radiologic results of arthroscopy-assisted hallux Valgus Deformity correction with percutaneous screw fixation. Methods: Ninety-four feet underwent arthroscopy-assisted hallux Valgus Deformity correction. Patients in whom the 1,2-intermetatarsal angle could be reduced manually and who had no significant abnormality of the distal metatarsal articular angle were included, and an endoscopic distal soft tissue procedure was performed. Those patients with first tarsometatarsal hypermobility, in whom the 1,2-intermetatarsal angle cannot be reduced manually, or those who had a significantly abnormal distal metatarsal articular angle were excluded. Patients were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux-metatarsophalangeal-interphalangeal scale. The pre- and postoperative hallux Valgus angle, intermetatarsal angle, distal metatarsal articular angle, and sesamoid position were measured. Results: The mean score on the AOFAS scale was 93 ± 8 out of 100 points. The hallux Valgus angle improved from 33° ± 7° (range, 20° to 58°) to 14° ± 5° (range, 4° to 30°). The intermetatarsal angle improved from 14° ± 3° (range, 10° to 26°) to 9° ± 2° (range, 5° to 18°). Complications of hallux varus, skin impingement, screw breakage, and first metatarsophalangeal stiffness were experienced. Two patients with symptomatic recurrence had revision operation performed. Conclusions: Our study shows that arthroscopic correction of the hallux Valgus Deformity can achieve good clinical and radiologic results, provided that careful preoperative clinico–radiologic assessment is made to exclude patients contraindicated for the procedure. Level of Evidence: Level IV, therapeutic case series.
Sushrut Babhulkar - One of the best experts on this subject based on the ideXlab platform.
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total knee arthroplasty for severe Valgus Deformity
Journal of Bone and Joint Surgery American Volume, 2005Co-Authors: Amar S Ranawat, Chitranjan S Ranawat, Mark Elkus, Vijay J Rasquinha, Roberto Rossi, Sushrut BabhulkarAbstract:BACKGROUND: In 1985, the senior author (C.S.R.) developed a new soft-tissue release technique to balance Valgus knees to avoid unacceptably high rates of late-onset instability and the need for primary constrained implants. This report describes the soft-tissue release technique and its long-term results when performed in primary total knee arthroplasty in patients with a severe Valgus knee Deformity. METHODS: Four hundred and ninety consecutive total knee arthroplasties were performed by one surgeon between January 1988 and December 1992. In this group, seventy-one patients (eighty-five knees) had a Valgus Deformity of 10°. Thirty-two patients (thirty-six knees) died, and four patients (seven knees) were lost to follow-up, leaving thirty-five patients (forty-two knees) followed for a minimum of five years. These twenty-seven women and eight men had a mean age of sixty-seven years at the time of the index operation. The technique included an inside-out soft-tissue release of the posterolateral aspect of the capsule with pie-crusting of the iliotibial band and resection of the proximal part of the tibia and distal part of the femur to provide a balanced, rectangular space. Cemented, posterior stabilized implants were used in all knees. Clinical and radiographic evaluations were performed at one, five, and ten years postoperatively. RESULTS: The mean modified Knee Society clinical score improved from 30 points preoperatively to 93 points postoperatively, and the mean functional score improved from 34 to 81 points. The mean range of motion was 110° both preoperatively and postoperatively. The mean coronal alignment was corrected from 15° of Valgus preoperatively to 5° of Valgus postoperatively. Three patients underwent revision surgery because of delayed infection, premature polyethylene wear, and patellar loosening in one patient each. There were no cases of delayed instability. CONCLUSIONS: The inside-out release technique to correct a fixed Valgus Deformity in patients undergoing primary total knee arthroplasty is reproducible and provides excellent long-term results.
