Epiphysiodesis of the first ray as a method of treat-ment of adolescent hallux valgus

Abstract

Presentation of short-term results from the application of epiphysiodesis of the first ray as a method of treatment of adolescent hallux valgus.
 Material and method: The operative technique was introduced in USHATO in January 2018 like a operative procedure for treatment of mild and moderate deformity of adolescent hallux valgus (AHV). The technique includes percutaneous access to the growth zones in the area of ​​the first metatarsal bone and proximal phalanx and partial epiphysiodesis of the growth complex. The study presents 12 cases in 9 children with a mean age of 10.1 years (min. 5 years, max. 13 years). Most of the patients were female - 77.78%. According to the three-dimensional Stantrock classification and the HV severity classification, the twelve cases fell into group II-A and moderate severity. Three angular parameters hallux valgus angle(HVA), intra-metatarsal angle (IMA), distal-metatarsal articulation angle (DMAA), were used to monitor the results, and the measurements were performed preoperatively, intraoperatively and postoperatively.
 The American Orthopaedic Foot and Ankle Society (AOFAS), was used to report clinical outcomes.
 Results: Patients were followed up for a mean period of 17.58 months. For this period we do not established postoperative recurrences, and all cases remain in the same group according Stantrock classification and the HV severity classification.
 In the three monitored radiographic parameters we report clinical, but not statistical improvement: HVA by an average of 1.19°, IMA by an average of 0.55° and loss of correction in DMAA by 0.9°. For the follow-up period, we report a statistical improvement in the clinical parameters reported on the AOFAS scale (p <0.4).