Maintenance of Correction of First Metatarsal Closing Base Wedge Osteotomies Versus Modified Lapidus Arthrodesis for Moderate to Severe Hallux Valgus Deformity

• Published in: The Journal of foot and ankle surgery 2007-09, Vol.46 (5), p.358-365
• Main Authors: Haas, Zachary, DPM, Hamilton, Graham, DPM, Sundstrom, Daisy, DPM, Ford, Lawrence, DPM
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Arthrodesis - methods; Biological and medical sciences; closing base wedge osteotomy; Cohort Studies; correction; Diseases of the osteoarticular system; Foot Bones - diagnostic imaging; hallux valgus; Hallux Valgus - diagnostic imaging; Hallux Valgus - surgery; Humans; lapidus arthrodesis; Malformations and congenital and or hereditary diseases involving bones. Joint deformations; Medical sciences; Metatarsal Bones - surgery; Middle Aged; Orthopedic surgery; Orthopedics; Osteotomy - methods; radiographic analysis; Radiography; Reproducibility of Results; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2007.05.008

A retrospective radiographic review of 57 feet was conducted to compare maintenance of correction of the modified Lapidus arthrodesis with the first metatarsal closing base wedge osteotomy for moderate to severe hallux valgus deformity. Radiographic parameters were measured on the preoperative, early postoperative, and greater than 11-month postoperative weightbearing radiographs. These measurements included the intermetatarsal angle, the hallux abductus angle, and the tibial sesamoid position. The patients who underwent the closing base wedge osteotomy had an average initial intermetatarsal correction of 10.4°; for the modified Lapidus arthrodesis, it was 7.6°. The patients who underwent the closing base wedge osteotomy had an average loss of intermetatarsal correction of 2.55° from early to late postoperative radiographs; for the modified Lapidus arthrodesis, it was 1.08°. Our results demonstrated that the modified Lapidus arthrodesis maintains correction to a greater degree than the first metatarsal closing base wedge osteotomy with statistical significance ( P = .0039). Both the modified Lapidus arthrodesis and the first metatarsal closing base wedge osteotomy are effective procedures with respect to degree of radiographic correction for moderate to severe hallux valgus deformities.