The modified coughlin osteotomy for surgical treatment of high-grade tailor’s bunion

Abstract

Category: Lesser Toes Introduction/Purpose: To explore the surgical method of using the modified coughlin osteotomy for surgical treatment of high-grade tailor’s bunion and report the clinical outcomes Methods: From March 2013 to April 2015, the modified coughlin osteotomy was used for surgical treatment of high-grade tailor’s bunion. Twenty-two patients with 31 feet high-grade tailor’s bunion were hospitalized for treament in Xuzhou Central Hospital. There were 3 male (3 feet) and 19 female (28 feet) cases, aged 26 -78 years (mean 45.3y) old. The mean course of the painful bunionette disease was 6.7 years (range, 2 to 38 y). The average 4-5 intermetatarsal angle, fifth metatarsophalangeal angle and lateral deviation of the fifth metatarsal angle were 16.3°±5.1°, 10.7°±3.5° and 5.8°±2.6°, respectively. Main outcome measures included the 4-5 intermetatarsal angle, the fifth metatarsophalangeal angle, pain and appearance. Patients were scored using the American Orthopaedic Foot & 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, 6 to 30 months). The mean fracture healing time was 11.6 weeks(range, 6 to 14 weeks), X-ray photograph proved fracture healing with a good positoin.All the patients had satisfactory appearance and sensory function witout callosum and metastatic metatarsalgiaat the final follow-up. The preoperatively 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. The mean AOFAS score was 89.0±8.4. Conclusion: The modified coughlin osteotomy is a safe and easy treatment option for the high-grade tailor’s bunion deformity and provides patient satisfaction results