Lateralising DMMO (MIS) for simultaneous correction of a pes adductus during surgical treatment of a hallux valgus

• Published in: Foot (Edinburgh, Scotland) Scotland), 2020-12, Vol.45, p.101722-101722, Article 101722
• Main Authors: Chomej, Pawel, Klos, Kajetan, Bauer, Stefan, Walther, Markus
• Format: Article
• Language: English
• Subjects: Chevron; DMMO; Hallux valgus; MIS; Percutaneous; Pes adductus
• ISSN: 0958-2592; 1532-2963
• DOI: 10.1016/j.foot.2020.101722

•Pes adductus – not an easy task during the operative therapy of hallux valgus.•An interesting and effective modification of a DMMO to treat the pes adductus.•Lateralising DMMO is an easy to perform and safe MIS-Procedure.•Lateralising DMMO can be combined with any MIS and open procedures.•Corrected adductus improves the long-term results of the hallux valgus correction. The surgical correction of a hallux valgus deformity presenting with a pes adductus has long proven to be a difficult undertaking. The medial shift of the metatarsal bones limits the scope for surgical correction and leads to inherently high reoccurrence rates. Current invasive treatments often give rise to profound soft tissue trauma and prolonged swelling, while requiring strict relief from weight-bearing in the affected foot. In this paper, it is aimed to introduce an easy and useful modification of the Distal Metatarsal Minimal-invasive Osteotomy (DMMO) to perform the effective, simultaneous correction of a pes adductus during surgical treatment of a hallux valgus. We followed-up 143 patients with a hallux valgus and simultaneous pes adductus deformity who underwent one of three additional interventions contemporaneous to the lateralising DMMO: 1.mini-open Lapidus arthrodesis (Hybrid LAP)2.percutaneous, proximal MT 1 closing wedge-osteotomy (pCLW)3.percutaneous Chevron and Akins (pCA) The assessment of radiological and clinical outcomes after a follow-up period of 12-25 months showed a sustained and effective correction of the pes adductus with a well-aligned hallux. The surgery was characterised by a low incidence of postoperative complications and high patient satisfaction while allowing for pain-adapted, post-operative weight-bearing. Level of Clinical Evidence: 3.