First metatarsal Pronation is increasingly recognised as an important component of Hallux valgus (HV) and can contribute towards intraoperative malreduction, postoperative recurrence and patient reported outcome measures (1,2,3). There are numerous radiological ways to measure metatarsal rotation on plain radiographs and weight bearing CT (WBCT), however there are no clinical tests to evaluate metatarsal pronation pre- or intra-operatively. This study therefore aimed to examine the relationship between clinical pronation of the toe and metatarsal pronation. Single-centre, retrospective analysis over 5 years. Measurements were performed on WBCT images with digital reconstructions to add soft tissues. First metatarsal rotation was measured using the Metatarsal Pronation Angle as previously described (4). Toe rotation was measured by the Phalangeal Condylar Angle (PCA), the angle between the condyles of the proximal phalanx and the floor, and the Nail Plate Angle (NPA), the angle of the base of the nail plate to the floor in the coronal Plane. These were obtained from 50 feet in Hallux valgus patients, and 50 control patients with CTs done for osteochondral lesions without hallux valgus or hindfoot malalignment.Aims
Methods
Minimally invasive (percutaneous) distal first metatarsal osteotomy with internal fixation is an established technique for hallux valgus deformity correction. Published data is limited to 2–3 years follow-up. This study aimed to assess patients undergoing MICA (Minimally Invasive Chevron and Akin) with minimum 5-year follow up, to evaluate the longer-term results of this procedure using validated patient reported outcome measures (PROMs). Five-year PROM data was prospectively collected from 117 patients who underwent 169 primary MICA osteotomies between July 2014 and April 2018, performed by a single surgeon. Primary clinical outcome measures included visual analogue scale for pain (VAS-pain), Manchester-Oxford Foot Questionnaire (MOXFQ) and EuroQol-5 Dimensions Index (EQ-5D). Data were collected preoperatively, at 2 years and after a minimum of 5 years. Statistical significance was set at p< 0.05.Introduction
Methods
