Abstract
We present our results in 89 consecutive patients (138 feet), minimum FU of 24/12.
Methods: Typical indications were IM angles > 13 degrees, incongruent MTP1 joints.
Contraindications included abnormal DMMA, significant 1st MTP arthritis, hypermobility of 1st MTC joint, revision surgery.
All patients underwent a 3-in-1 procedure with soft tissue release in 1stwebspace, medial bunionectomy with capsulorraphy and basal crescentic osteotomy.
A 25 mm blade on oscillating driver was used. Fixation was staples(70%),screws(20%),K- wires(10%).
Post op, PWB, progressing to FWB at 3/52.
AOFAS forefoot scores at pre-op, 6/12, 12/12 and 24/12.
Weight bearing radiographs obtained at pre-op, 3/12, 12/12.
Results:
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M:F=19:70
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Age 31–79 (Mean 64)
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89 patients, 138 feet
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AOFAS scores improved from average 42/100 preop to 76/100 at 6/12.
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Radiographic correction excellent in78% of patients.
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74 % of patients extremely satisfied,15 %satisfied,11 %unsatisfied with outcome.
Complications:
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Nonunion=2
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Infection=2 superficial,1 deep
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Recurrence of deformity at 6/12 = 2
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12/12 = 2
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Transfer metatarsalgia M2 due to overriding of distal M1=3
Conclusions: Basal Dome Osteotomy with soft tissue correction is powerful and reproducible for the correction of moderate and severe Hallux Valgus. There is an initial learning curve. Much less soft tissue dissection required compared to the SCARF procedure. Results are very satisfactory.
Correspondence should be addressed to the Honorary Secretary, BOFSS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
