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Year 2015, Volume: 49 Issue: 6, 648 - 653, 28.10.2015

Yunus Emre Akman , Merter Yalcinkaya , Esra Circi Yunus Atici Yusuf Ozturkmen Ahmet Dogan

https://doi.org/10.3944/AOTT.2015.14.0289

Abstract

Amaç: Bu çalışmamızda, erişkinlerde gözlenen orta veya ağır dereceli halluks valgus deformitesi olgularında, birinci metatarsın proksimal, medial tabanlı, açık kama osteotomisinde kullanılan modifiye Simmonds-Menelaus tekniğinin klinik ve radyolojik sonuçları sunulmaktadır.Çalışma planı: Halluks valgus nedeniyle 47 hastanın 51 ayağı opere edilmişti. Ortalama yaşı 41.2±14.0 olan hastaların ortalama takip sürelerinin 99.5±36.0 ay olduğu kaydedildi. Hastaların değerlendirmesi cerrahi öncesi, cerrahiden sonra erken dönem ve son takiplerinde çekilen ayakta anteroposterior (AP) ve lateral grafilerle yapıldı. Halluks valgus açısı (HVA), intermetatarsal açı (İA), metatars distal falanks açısı (MDFA), birinci metatars uzunluğu (MU) parametreleri ölçüldü. Klinik değerlendirmede AOFAS halluks metatarsofalangeal-interfalangeal skaladan yararlanıldı.Bulgular: Ortalama HVA cerrahi öncesi 36.9±7.3 derece olarak ölçülürken, cerrahi sonrası erken dönemde bu değerin 16.6±6.2, son takipte ise 28.9±11.5 derece olduğu görüldü. Ortalama İA cerrahi öncesinde 17.3±4.5, cerrahi sonrası erken dönemde 8.8±3.6 ve son takipte 14.3±4.9 derece olarak ölçüldü. Son takipteki ortalama AOFAS halluks metatarsofalangeal-interfalangeal skala puanı ise 71.9±20.1 idi.Çıkarımlar: Literatürdeki diğer çalışma sonuçlarıyla karşılaştırıldığında, erişkinlerde başarılı sonuç alınamamasının proksimal açık kama osteotomi tekniğinin kendisinden mi yoksa internal tespit yetersizliğinden mi kaynaklandığı net olarak anlaşılamamaktadır. Greftin çökmesini önlemek ve düzeltilmiş radyolojik parametrelerin kalıcılığını sağlamak için uygun tespit materyalinin kullanılması şarttır

Keywords

Distal yumuşak doku gevşetmesi; halluks valgus; modifiye Simmonds-Menelaus tekniği; proksimal osteotomi

References

  • Coughlin MJ, Mann RA, Saltzman CL. Surgery of the foot and ankle. Vol 1, 183–362, 8th edition, Mosby Else- vier, Philadelphia, 2007.
  • Haınes Rw, Mcdougall A. The anatomy of hallux valgus. J Bone Joint Surg Br 1954;36–B:272–93.
  • Mann RA, Coughlin MJ. Hallux valgus--etiology, anat- omy, treatment and surgical considerations. Clin Orthop Relat Res 1981;157:31–41.
  • Ben-Ad R. Fixation updates for hallux valgus correction. Clin Podiatr Med Surg 2014;31:265–79.
  • Canale T, Beaty J. Campbell’s Operative Orthopaedics. Chapter 78, Disorder of hallux, 4471–4563 11th edition, Mosby Elsevier, 2007.
  • Sammarco GJ, Idusuyi OB. Complications after surgery of the hallux. Clin Orthop Relat Res 2001;391:59–71.
  • Trethowan J. Hallux Valgus. In A System of Surgery, Ed. C.C. Choyce, New York P.B. Hoeber 1923. p. 1046–9.
  • Simmonds FA, Menelaus MB. Hallux valgus in adoles- cents. J Bone joint surg 1960;42:761–68.
  • Andreacchio A, Origo C, Rocca G. Early results of the modified Simmonds-Menelaus procedure for adolescent hallux valgus. J Pediatr Orthop 2002;22:375–9.
  • Coughlin MJ. Hallux valgus. J Bone Joint Surg Am 1996;78:932–66.
  • Okuda R, Kinoshita M, Yasuda T, Jotoku T, Shima H, Takamura M. Hallux valgus angle as a predictor of recur- rence following proximal metatarsal osteotomy. J Orthop Sci 2011;16:760–4.
  • Sammarco VJ. Surgical correction of moderate and severe hallux valgus: proximal metatarsal osteotomy with distal soft-tissue correction and arthrodesis of the metatarso- phalangeal joint. Instr Course Lect 2008;57:415–28.
  • Budny AM, Masadeh SB, Lyons MC 2nd, Frania SJ. The opening base wedge osteotomy and subsequent lengthen- ing of the first metatarsal: an in vitro study. J Foot Ankle Surg 2009;48:662–7.
  • Ferrao PN, Saragas NP2. Rotational and opening wedge basal osteotomies. Foot Ankle Clin 2014;19:203–21.
  • Badekas A, Georgiannos D, Lampridis V, Bisbinas I. Proximal opening wedge metatarsal osteotomy for correc- tion of moderate to severe hallux valgus deformity using a locking plate. Int Orthop 2013;37:1765–70.
  • Nery C, Réssio C, de Azevedo Santa Cruz G, de Oliveira RS, Chertman C. Proximal opening-wedge osteotomy of the first metatarsal for moderate and severe hallux valgus using low profile plates. Foot Ankle Surg 2013;19:276– 82.
  • Tóth K, Huszanyik I, Kellermann P, Boda K, Róde L. The effect of first ray shortening in the development of meta- tarsalgia in the second through fourth rays after metatarsal osteotomy. Foot Ankle Int 2007;28:61–3.

Modified Simmonds-Menelaus procedure for moderate or severe adult hallux valgus

Year 2015, Volume: 49 Issue: 6, 648 - 653, 28.10.2015

Yunus Emre Akman , Merter Yalcinkaya , Esra Circi Yunus Atici Yusuf Ozturkmen Ahmet Dogan

https://doi.org/10.3944/AOTT.2015.14.0289

Abstract

Objective: The purpose of this study was to present the clinical and radiological results of modified Simmonds-Menelaus technique, performed as a proximal, medially-based, open-wedge osteotomy of the first metatarsal, in cases of moderate or severe adult hallux valgus deformity.
Methods: Fifty-one feet of 47 patients underwent surgery due to hallux valgus. Mean age was 41.2±14.0 years, and mean follow-up period was 99.5±36.0 months. Patients were evaluated with standing anteroposterior (AP) and lateral radiographies obtained in the preoperative and early postoperative periods, and during final follow-up. The parameters of hallux valgus angle (HVA), intermetatarsal angle (IA), metatarsal distal phalangeal angle (MDPA), and first metatarsal length (ML) were measured. For clinical evaluation, American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal (MTP-IP) scale was used.
Results: Mean preoperative HVA was 36.9°±7.3°, mean early postoperative HVA was 16.6°±6.2°, and mean final postoperative HVA was 28.9°±11.5°. Mean preoperative IA was 17.3°±4.5°, mean early postoperative IA was 8.8°±3.6°, and mean final postoperative IA was 14.3°±4.9°. Mean AOFAS hallux MTP-IP score was 71.9±20.1 at final follow-up.
Conclusion: From studies in the available literature, it is not clear whether the proximal open-wedge osteotomy technique itself is unsuccessful in adults or the lack of internal fixation led to failure. Application of an adequate fixation material should be used in order to avoid the collapse of the graft and to maintain the correction of the radiological parameters.

Keywords

Distal soft tissue release hallux valgus modified Simmonds-Menelaus procedure proximal osteotomy

References

  • Coughlin MJ, Mann RA, Saltzman CL. Surgery of the foot and ankle. Vol 1, 183–362, 8th edition, Mosby Else- vier, Philadelphia, 2007.
  • Haınes Rw, Mcdougall A. The anatomy of hallux valgus. J Bone Joint Surg Br 1954;36–B:272–93.
  • Mann RA, Coughlin MJ. Hallux valgus--etiology, anat- omy, treatment and surgical considerations. Clin Orthop Relat Res 1981;157:31–41.
  • Ben-Ad R. Fixation updates for hallux valgus correction. Clin Podiatr Med Surg 2014;31:265–79.
  • Canale T, Beaty J. Campbell’s Operative Orthopaedics. Chapter 78, Disorder of hallux, 4471–4563 11th edition, Mosby Elsevier, 2007.
  • Sammarco GJ, Idusuyi OB. Complications after surgery of the hallux. Clin Orthop Relat Res 2001;391:59–71.
  • Trethowan J. Hallux Valgus. In A System of Surgery, Ed. C.C. Choyce, New York P.B. Hoeber 1923. p. 1046–9.
  • Simmonds FA, Menelaus MB. Hallux valgus in adoles- cents. J Bone joint surg 1960;42:761–68.
  • Andreacchio A, Origo C, Rocca G. Early results of the modified Simmonds-Menelaus procedure for adolescent hallux valgus. J Pediatr Orthop 2002;22:375–9.
  • Coughlin MJ. Hallux valgus. J Bone Joint Surg Am 1996;78:932–66.
  • Okuda R, Kinoshita M, Yasuda T, Jotoku T, Shima H, Takamura M. Hallux valgus angle as a predictor of recur- rence following proximal metatarsal osteotomy. J Orthop Sci 2011;16:760–4.
  • Sammarco VJ. Surgical correction of moderate and severe hallux valgus: proximal metatarsal osteotomy with distal soft-tissue correction and arthrodesis of the metatarso- phalangeal joint. Instr Course Lect 2008;57:415–28.
  • Budny AM, Masadeh SB, Lyons MC 2nd, Frania SJ. The opening base wedge osteotomy and subsequent lengthen- ing of the first metatarsal: an in vitro study. J Foot Ankle Surg 2009;48:662–7.
  • Ferrao PN, Saragas NP2. Rotational and opening wedge basal osteotomies. Foot Ankle Clin 2014;19:203–21.
  • Badekas A, Georgiannos D, Lampridis V, Bisbinas I. Proximal opening wedge metatarsal osteotomy for correc- tion of moderate to severe hallux valgus deformity using a locking plate. Int Orthop 2013;37:1765–70.
  • Nery C, Réssio C, de Azevedo Santa Cruz G, de Oliveira RS, Chertman C. Proximal opening-wedge osteotomy of the first metatarsal for moderate and severe hallux valgus using low profile plates. Foot Ankle Surg 2013;19:276– 82.
  • Tóth K, Huszanyik I, Kellermann P, Boda K, Róde L. The effect of first ray shortening in the development of meta- tarsalgia in the second through fourth rays after metatarsal osteotomy. Foot Ankle Int 2007;28:61–3.
There are 17 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Yunus Emre Akman

Merter Yalcinkaya

Esra Circi This is me

Yunus Atici This is me

Yusuf Ozturkmen This is me

Ahmet Dogan This is me

Publication Date October 28, 2015
Published in Issue Year 2015 Volume: 49 Issue: 6

Cite

APA Akman, Y. E., Yalcinkaya, M., Circi, E., Atici, Y., et al. (2015). Modified Simmonds-Menelaus procedure for moderate or severe adult hallux valgus. Acta Orthopaedica Et Traumatologica Turcica, 49(6), 648-653. https://doi.org/10.3944/AOTT.2015.14.0289
AMA Akman YE, Yalcinkaya M, Circi E, Atici Y, Ozturkmen Y, Dogan A. Modified Simmonds-Menelaus procedure for moderate or severe adult hallux valgus. Acta Orthopaedica et Traumatologica Turcica. October 2015;49(6):648-653. doi:10.3944/AOTT.2015.14.0289
Chicago Akman, Yunus Emre, Merter Yalcinkaya, Esra Circi, Yunus Atici, Yusuf Ozturkmen, and Ahmet Dogan. “Modified Simmonds-Menelaus Procedure for Moderate or Severe Adult Hallux Valgus”. Acta Orthopaedica Et Traumatologica Turcica 49, no. 6 (October 2015): 648-53. https://doi.org/10.3944/AOTT.2015.14.0289.
EndNote Akman YE, Yalcinkaya M, Circi E, Atici Y, Ozturkmen Y, Dogan A (October 1, 2015) Modified Simmonds-Menelaus procedure for moderate or severe adult hallux valgus. Acta Orthopaedica et Traumatologica Turcica 49 6 648–653.
IEEE Y. E. Akman, M. Yalcinkaya, E. Circi, Y. Atici, Y. Ozturkmen, and A. Dogan, “Modified Simmonds-Menelaus procedure for moderate or severe adult hallux valgus”, Acta Orthopaedica et Traumatologica Turcica, vol. 49, no. 6, pp. 648–653, 2015, doi: 10.3944/AOTT.2015.14.0289.
ISNAD Akman, Yunus Emre et al. “Modified Simmonds-Menelaus Procedure for Moderate or Severe Adult Hallux Valgus”. Acta Orthopaedica et Traumatologica Turcica 49/6 (October 2015), 648-653. https://doi.org/10.3944/AOTT.2015.14.0289.
JAMA Akman YE, Yalcinkaya M, Circi E, Atici Y, Ozturkmen Y, Dogan A. Modified Simmonds-Menelaus procedure for moderate or severe adult hallux valgus. Acta Orthopaedica et Traumatologica Turcica. 2015;49:648–653.
MLA Akman, Yunus Emre et al. “Modified Simmonds-Menelaus Procedure for Moderate or Severe Adult Hallux Valgus”. Acta Orthopaedica Et Traumatologica Turcica, vol. 49, no. 6, 2015, pp. 648-53, doi:10.3944/AOTT.2015.14.0289.
Vancouver Akman YE, Yalcinkaya M, Circi E, Atici Y, Ozturkmen Y, Dogan A. Modified Simmonds-Menelaus procedure for moderate or severe adult hallux valgus. Acta Orthopaedica et Traumatologica Turcica. 2015;49(6):648-53.