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Foot & Ankle

RADIOLOGICAL OUTCOME OF PATIENTS WITH SPLAY FOOT FOLLOWING 1ST AND 5TH METATARSAL OSTEOTOMIES PERFORMED SIMULTANEOUSLY ON THE SAME FOOT

British Orthopaedic Foot & Ankle Society (BOFAS)



Abstract

Background & aim

There have been many operations described for the treatment of hallux valgus deformities and b ette done separately with variable success rates. Our aim is to radiologically assess the outcome following simultaneous osteotomies to the 1st and 5th metatarsals in symptomatic patients with splay foot. To our knowledge, this procedure has not been described in the literature yet.

Materials & method

9 symptomatic patients (12 feet) were included in the study. The pre-operative and post-operative X-rays were assessed and the hallux valgus angles, 1st and 2nd intermetatarsal angles, distal metatarsal articular angles (DMAA), 4th and 5th intermetatarsal angles, maximum widths of the 1st and 5th metatarsal heads and the maximum distance between 1st and 5th metatarsals were calculated. The improvement in the angles and distances post-operatively were then assessed for statistical significance using Non-parametric paired T tests.

Results

Hallux valgus angles (pre op mean of 28.17o (range, 20o-40o), post-op. mean of 16.33o (range, 4o-30o)), inter-metatarsal angles (mean of 14o (range, 9o-20o) and a post-op. mean of 9.29o (range, 4o-14o)), 1st and 5th metatarsal head widths (pre-op mean of 2.27cm and 1.27cm respectively and a post-op. width of 1.87cm and 1.09cm respectively), and maximum distance between 1st and 5th metatarsals head (pre-op mean of 8.05cm (range, 7.4cm-9.1cm) and post-op mean of 7.15cm (range, 6.8cm-7.7cm) all have significantly decreased post-operatively (p< 0.05).

Conclusion

The results suggest a very good outcome in symptomatic patients following simultaneous 1st and 5th metatarsal osteotomies. All the angles measured except for the DMAA showed a statistically significant reduction post-operatively.