Vergleich zweier Operationsmethoden beim Hallux valgus- proximale keilförmige Metatarsale 1 Osteotomie vs. Großzehengrundgelenkarthrodese

Between 1999 and 2001, 73 patients (79 feet) were treated with a proximal metatarsal wedge osteotomy or an arthrodesis of the first metatarsophalangeal joint. At an average follow-up of 23 months + 4 month, 2 men and 34 women (40 feet) treated by proximal osteotomy, and 6 men and 13 women (20 feet) treated by arthrodesis were retrospectively reviewed. The mean age was 58 years, patients satisfaction was exzellent or good in 82,5% after proximal wedge osteotomy and 80% after arthrodesis. In the osteotomy- group 72,5% felt no pain in their feet, in the arthrodesis- group 65%. The Hallux Metatarosphalangeal- Interphalangeal Scale Kitaoka- Score (total 100 points) average was 87 points after proximal wedge osteotomy and 78 points after arthrodesis. The average hallux valgus (HV) angle was reduced from 35,1° preoperatively to 15,9° postoperatively (proximal wedge osteotomy) and 36,5° preoperatively to 15,4° postoperatively (arthrodesis). The value for the intermetatarsal angle (IM) were 16,6° to 12° (osteotomy) and 13,7° to 7,6° (arthrodesis). Complications included 1 case of hypaesthesia (osteotomy) and in 3 cases a decrease of correction (osteotomy). The conclusion is that proximal wedge osteotomy and arthrodesis are effective in correction hallux valgus deformity. No correlation between the preoperative hallux valgus angle and Kitaoka- Score value was found.