Modified Coughlin osteotomy for surgical treatment of III type tailor, s bunion

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Objective To explore the surgical method of the modified Coughlin osteotomy for surgical treatment of Ⅲ type tailor's bunion and report the clinical outcomes. Methods The data of 22 patients (31 feet) with Ⅲ type tailor's bunion deformity who were hospitalized for treatment in Xuzhou Central Hospital from March 2013 to April 2015 were retrospectively analyzed. There were 3 males (3 feet) and 19 females (28 feet), aged 26-78(mean 45.3) years old. The modified coughlin osteotomy was used for surgical treatment. Main postoperatively outcome measures included fracture healing, 4-5 intermetatarsal angle, the fifth metatarsophalangeal angle, lateral deviation of the fifth metatarsal angle, pain and appearance. Patients were scored using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser toe metatarsophalangeal-interphalangeal scale. Results All operations were performed with no complications. Primarily healing of the wound was achieved in all cases. All the patients were followed up for a mean time of 17.8 months (range from 6 to 30 months). The mean fracture healing time was 11.6 weeks (range, 6 to 14 weeks). All the patients had satisfactory appearance and sensory function without callosum and metastatic metatarsalgia at the final follow-up. At the final follow-up, the average 4-5 intermetatarsal angle, fifth metatarsophalangeal angle and lateral deviation of the fifth metatarsal angle were 5.9°±1.6°, 6.1°±2.3° and 2.2°±1.2°, respectively, and were less than those of preoperatively angles of 16.3°±5.1°, 10.7°±3.5°, 5.8°±2.6°, respectively, with statistically significant difference(t=10.833, 6.115, 7.000, all P values<0.01); the mean AOFAS score was 89.0±8.4, which was more than that of preoperatively value of 60.2±9.3 with statistically significant difference (t=12.795, P<0.01). Conclusions The modified coughlin osteotomy is a safe and easy treatment option for the Ⅲ type tailor's bunion deformity and provides patient satisfaction results. Key words: Bunion, tailor's; Osteotomy; Coughlin osteotomy; Reconstructive surgical procedures