Evaluation of Sesamoid Bone Reduction in Hallux Valgus Patients Treated With Three Different Osteotomy

Abstract

Aim:The aim of this study is to investigate the effect of three different osteotomies on sesamoid rotation in hallux valgus surgery. Patients and Method: 64 out of 108 patients between March 2012-January 2015 were included retrospectively. Procedure of distal chevron, proximal dome and lapidus was applied to 26,18 and 20 patients respectively. Mean age of patients was 46,6 (26-62) and mean time of follow-up was 17 months. Results: At the last follow - up of patients, the mean hallux valgus angle was 18.4º, intermetatarsal angle was 7.4 º, AOFAS score was 86.1, sesamoid rotation was 13,5. When three different osteotomies were compared in terms of preop and postop sesamoid rotation differences in terms of their ability to correct most sesamoid position within themselves, a significant difference was found in patients treated with lapidus osteotomy in terms of success of sesamoid reduction compared to both patients treated with proximal dome osteotomy (p: 0.02) and patients treated with distal chevron osteotomy (p: 0.000). There was no significant difference in the success rate of sesamoid reduction between patients with proximal dome and patients with distal chevron. (P = 0.242) Discussion: Patients treated with lapidus osteotomy; both sesamoid rotation angle changes and sesamoid reduction were found to be better than the other two osteotomy types. According to the study, we think that the lapidus procedure will give better results in patients with moderate and severe hallux valgus when sesamoid reduction is considered to be related to recurrence.