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Abstract
BackgroundHallux valgus (HV) is a complex deformity of the forefoot altering the kinematics of walking. Many different treatment alternatives exist for the correction of hallux valgus, but to date, none has been shown to be more effective than any other. The rate of complications following hallux valgus surgery is variable and has been reported as ranging from 1 to 55 % in the scientific literature. The purpose of this preliminary prospective study was to evaluate the result of the Endolog device, an innovative titanium endomedullary nail, for the treatment of HV.MethodsThirty patients with mild-to-severe HV were treated with the Endolog device. Clinical evaluation was assessed preoperatively, as well as at 3, 6, 12, 24, and 48 months after surgery with a final follow-up at 4 years, using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux grading system. Computer-assisted measurement of weight-bearing antero-posterior radiographs was taken preoperatively and postoperatively, as well as at 3, 6, 12, 24, and 48 months after surgery. Non-weight-bearing radiographs were taken before the patients were discharged. The radiological parameters measured included the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA), and the tibial sesamoid position. Statistical analysis was carried out using the paired t test (p < 0.05).ResultsThe mean AOFAS score was 93.98 points at the 48-month follow-up. The postoperative radiographic assessments showed a statistically significant improvement compared with preoperative values. The mean corrections for each angular value at the last follow-up were as follows: IMA 5.95°; HVA 16.81°; DMAA 10.70°; and tibial sesamoid 1.36°.ConclusionThe Endolog is a safe and effective technique for the correction of HV deformity, to relieve pain and to preserve joint movement.
Highlights
Hallux valgus (HV) is a complex deformity of the forefoot altering the kinematics of walking
HV is considered a progressive deformity characterized by subluxation of the first metatarsophalangeal joint (MTPJ) with lateral displacement and pronation of the big toe, metatarsus varus, exostosis of the metatarsal head, and instability of the first tarsometatarsal joint (TMTJ)
In accordance with other investigators’ reports [10, 16, 20,21,22,23], it has been found that an internal device such as the Endolog, which ensures a stable, but not rigid synthesis of distal osteotomy, is linked to a significant improvement in all of the clinical parameters assessed and in particular in pain alleviation, alignment, and elimination of plantar keratotic lesions
Summary
Hallux valgus (HV) is a complex deformity of the forefoot altering the kinematics of walking. The rate of complications following hallux valgus surgery is variable and has been reported as ranging from 1 to 55 % in the scientific literature The purpose of this preliminary prospective study was to evaluate the result of the Endolog device, an innovative titanium endomedullary nail, for the treatment of HV. HV is considered a progressive deformity characterized by subluxation of the first metatarsophalangeal joint (MTPJ) with lateral displacement and pronation of the big toe, metatarsus varus, exostosis of the metatarsal head, and instability of the first tarsometatarsal joint (TMTJ). It is often associated with callus, bursa over the bony prominence, and lesser toe deformities [5]. A wide variety of surgical procedures have been described in the literature [6] for its correction including first metatarsal
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