Osteotomía percutánea de la falange distal del hallux. Indicaciones y técnica

  1. Juan Manuel Yañez Arauz 1
  2. Juan Martín Yañez Arauz 2
  3. Verónica Montiel Terrón 3
  4. Verónica Machado 3
  5. Matías Alfonso 3
  6. Carlos Villas-Tomé 3
  1. 1 Sector Pierna, Tobillo y Pie, Servicio de Ortopedia y Traumatología, Hospital Universitario Austral, Buenos Aires, Argentina
  2. 2 Facultad de Ciencias Biomédicas, Universidad Austral, Derqui, Buenos Aires, Argentina
  3. 3 Departamento de Cirugía Ortopédica y Traumatológica, Clínica Universidad de Navarra, Navarra, España
Mostrar afiliaciones +
Revista:
Revista de la Asociación Argentina de Ortopedia y Traumatología

ISSN: 1852-7434

Año de publicación: 2021

Volumen: 86

Número: 2

Páginas: 139-150

Tipo: Artículo

DOI: 10.15417/ISSN.1852-7434.2021.86.1.1097 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Revista de la Asociación Argentina de Ortopedia y Traumatología

Objetivos de desarrollo sostenible

Resumen

Introduction: There are many techniques to correct the hallux deformity. Most of them include metatarsal and/or phalanx osteoto-mies. The Akin osteotomy of the proximal phalanx is used to correct the distal articular set angle (DASA), or the interphalangeal angle. However, indications for the distal phalanx osteotomy remain unpublished. The aim of this study is to communicate the technique indications for percutaneous osteotomy of the distal phalanx of the hallux, and to evaluate the results of a case series. materials and methods: We reported 14 cases in which distal phalangeal osteotomy was performed. Radiographic measure-ments were performed on dorsal-plantar view of the foot, to analyze distal articular set angle (DASA), interphalangeal obliquity, and F2-IP angle. The surgical technique was performed by minimally incision surgery. The clinical and functional results were evaluated by the visual analog scale for pain and the AOFAS score. The average follow-up was 52 months. Results: The clinical outcomes for all the patients was excellent, pain was relieved and deformities corrected. Pre- and post-operative comparative angles: DASA (p: 0.01), except when isolated from the sample for Akin-type osteotomy (p: 0.33). Angle F2-IP and angle F2-MTP (p: <0.00001). The patients where highly satisfied with both the aesthetic and functional results. Complications were registered. Conclusion: In the symptomatic hallux distal phalanx deformity a corrective distal phalanx osteotomy should be considered alone, or associated with the osteotomy of the proximal phalanx. Percutaneous distal phalanx osteotomy is an effective, safe, and fast procedure.

Referencias bibliográficas

  • Mann RA, Coughlin MJ. Hallux valgus-etiology, anatomy, treatment and surgical considerations. Clin Orthop Relat Res 1981;(157):31-41. PMID:7249460
  • Myerson MS. Hallux valgus. En: Myerson MS (ed.). Foot and ankle disorders. Philadelphia: Saunders; 2000.
  • Coughlin MJ, Thompson FM. The high price of high-fashion footwear. Instr Course Lect 1995;44:371-7. PMID: 7797875
  • Coughlin MJ. Hallux valgus in men: Effect of the distal metatarsal articular angle on hallux valgus correction. Foot Ankle Int 1997;18(8):463-70. https://doi.org/10.1177/107110079701800802
  • Haines RW. Shoe design and toe deformation. Lancet 1954; 267(6852):1308-11. https://doi.org/10.1016/s0140-6736(54)90712-6
  • Lelievre J. Shoes and our foot. III. The physiological shoe. Concours Med 1961;83:1081-4. PMID: 13760672
  • Frey C, Thompson F, Smith J. Update on women’s footwear. Foot Ankle Int 1995;16(6):328-31. https://doi.org/10.1177/107110079501600603
  • Craigmile DA. Incidence, origin, and prevention of certain foot defects. Br Med J 1953;2(4839):749-52. https://doi.org/10.1136/bmj.2.4839.749
  • Coughlin MJ. Women’s shoe wear and foot disorders. West J Med 1995;163(6):569-70. https://doi.org/10.1177/107110079501600603
  • Coughlin MJ. Roger A. Mann Award. Juvenile hallux valgus: etiology and treatment. Foot Ankle Int 1995;16(11): 682-97. https://doi.org/10.1177/107110079501601104
  • Daw SW. An unusual type of hallus valgus (two cases). BMJ 1935; 2:580-2.
  • Sorto Jr LA, Balding MG, Weil LS, Smith SD. Hallux abductus interphalangeus. Etiology, X-ray evaluation and treatment. 1975. J Am Podiatr Med Assoc 1992;82(2):85-97. https://doi.org/10.7547/87507315-82-2-85
  • Akin OF. The treatment of hallux valgus-a new operative procedure and its results. Medical Sentinel 1925;33:678.
  • Hayes MHS, Patterson DG. Experimental development of the graphic rating method. Psychological Bulletin 1921;18:98-99.
  • Zealley AK, Aitken RCB. A growing edge of measurement of feelings [Abridged]: Measurement of mood. Proc R Soc Med 1969;62(10):993-6. PMID: 5346176
  • Mann R, Coughlin M. Hallux valgus y sus complicaciones. En: Cirugía del pie, 5ª ed. Buenos Aires: Editorial Médica Panamericana; 1986.
  • Barnett CH. Valgus deviation of the distal phalanx of the great toe. J Anat 1962;96(Pt 2):171-7. PMID: 13865114
  • Bryant JA. A comparison of radiographic foot measurements taken in two different positions. J Am Podiatr Med Assoc 2001;91(5):234-9. https://doi.org/10.7547/87507315-91-5-234
  • Coughlin MJ, Shurnas PS. Hallux rigidus: demographics, etiology, and radiographic assessment. Foot Ankle Int 2003;24(10):731-43. https://doi.org/10.1177/107110070302401002
  • Sorto LA, Balding MG, Weil LS, Smith SD. Hallux abductus interphalangeus: etiology, x-ray evaluation and treatment. J Am Podiatry Assoc 1976;66(6):384-96. https://doi.org/10.7547/87507315-66-6-384
  • Fitzgerald JA. A review of long-term results of arthrodesis of the first metatarso-phalangeal joint. J Bone Joint Surg Br 1969;51(3):488-93. PMID: 5820792
  • Barnett CH. The normal orientation of the human hallux and the effect of footwear. J Anat 1962;96(Pt 4):489-94. PMID: 13969386
  • Shimizu A, Watanabe S, Kamada K, Tsuboi I, Yamamoto H. Hallux valgus interphalangeus following osteochondral fracture of the proximal phalanx: a case report. Foot Ankle Int 2005;26(11):994-6. https://doi.org/10.1177/107110070502601116
  • Carnevale V. Phalanx valga of the great toe (“phalanx valga hallucis”) or clinodactyly of the great toe. Prensa Médica Argentina 1959;46:761-3.
  • Parrinello JF, Japour CJ, Dykyj D. Incurvated nail. Does the phalanx determine nail plate shape? J Am Podiatr Med Assoc 1995;85:696-8. https://doi.org/10.7547/87507315-85-11-696
  • Villas C, Del Rio J, Valenti A, Alfonso M. Symptomatic medial exostosis of the great toe distal phalanx: a complication due to over-correction following Akin osteotomy for hallux valgus repair. J Foot Ankle Surg 2009;48(1):47-51. https://doi.org/10.1053/j.jfas.2008.08.011
  • Barouk LS, Barouk P, Baudet B, Toullec E. The great toe proximal phalanx osteotomy: the final step of the bunionectomy. Foot Ankle Clin 2005;10(1):141-55. https://doi.org/10.1016/j.fcl.2004.09.006
  • Vander Griend R. Correction of hallux valgus interphalangeus with an osteotomy of the distal end of the proximal phalanx (distal Akin osteotomy). Foot Ankle Int 2017;38(2),153-8. https://doi.org/10.1177/1071100716670389
  • Burry HAS. The effect of shoes on hallux valgus: a significant study. Research Report 147: British Boot, Shoe and Allied Trades Research Association.
  • Valentí A, Montiel V, Alfonso M, Villas C. Feasibility of open and percutaneous corrective osteotomies of the second phalanx of the great toe. An approach on a cadaveric model. Foot (Edinb) 2019;38:39-42. https://doi.org/10.1016/j.foot.2018.12.001
Fuente de los datos: Dialnet