Olaf Bunion: A Norwegian Fairy Tale

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Women with mild HV present with pathologically increased pressure under the Hallux , which is caused by the altered alignment of the first ray. Pain and clinical result were associated with the pressure under the 1st MTH and the remaining variables were only moderate predictors of dynamic plantar pressures.

All rights reserved. Hallux valgus surgery affects kinematic parameters during gait. Background The aim of our study was to compare spatiotemporal parameters and lower limb and pelvis kinematics during the walking in patients with hallux valgus before and after surgery and in relation to a control group.

Methods Seventeen females with hallux valgus , who underwent first metatarsal osteotomy, constituted our experimental group. The control group consisted of thirteen females.

Kinematic data during walking were obtained using the Vicon MX system. Findings Our results showed that hallux valgus before surgery affects spatiotemporal parameters and lower limb and pelvis kinematics during walking. Hallux valgus surgery further increased the differences that were present before surgery. The asymmetry in the hip and the pelvis movements in the frontal plane present preoperatively persisted after surgery.

It is a long-term progressive malfunction of the foot affecting the entire kinematic chain of the lower extremity.

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The relationship of abnormal foot pronation to hallux abducto valgus --a pilot study. Abnormal foot mechanics is the most common cause of hallux abducto valgus. To date no quantitative data regarding the relationship between abnormal foot mechanics and the degree of hallux abducto valgus has been presented. An outline of the abnormal foot mechanics responsible for hallux abducto valgus is described along with a technique for measuring the extent of abnormal function. A common intrinsic abnormality responsible for hallux abducto valgus is described along with its diagnosis and orthotic treatment.

A previous study has shown an increased radiographic prevalence and severity of hallux valgus interphalangeus HVIP after surgical correction of hallux valgus HV due to correction of pronation deformity. The purpose of this study was to evaluate the change in pre- and postoperative HVIP deformity with correction of HV with multiple radiographic parameters. A retrospective chart review identified all bunion surgeries performed at a single center from July 1, , to September 30, Exclusion criteria included prior bony surgery to the first ray, inadequate films, nonadult bunion, Akin osteotomy, or surgical treatment other than bunion correction.

Pre- and postoperative films were reviewed for 2 HV angular measurements and 5 HVIP measurements, which were compared. Prevalence of HVIP was analyzed in pre- and postoperative radiographs.

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A 1-sided Student t test was used to compare continuous data, and a chi-square test was used to compare categorical data. Ninety-two feet in 82 patients were eligible. The average preoperative HV improved with surgery.

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Preoperative HVA improved from 27 to 11 degrees P [Distal osteotomy for the treatment of hallux valgus Chevron osteotomy ]. Distal osteotomies, like the Chevron osteotomy, is indicated for mild to moderate hallux valgus deformities.

Splayfoot, painful pseudoexostosis, and transfer metatasalgia are observed in the clinical examination. Radiographic examination should be done with weight bearing in two planes.

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Preoperatively the intermetatarsal IM , hallux valgus , and distal metatarsal articular DMAA angles should be measured. The operative technique is based on soft tissue and bony correction. The Gibson and Piggott osteotomy for adult hallux valgus. The Gibson and Piggott procedure for hallux valgus is based on sound surgical principles addressing the basic pathologies of this disorder.

However, this procedure has not been studied extensively in the literature in comparison to the Mitchell and Chevron osteotomies. We report a prospective study conducted on 50 adult feet with hallux valgus. The Gibson and Piggot osteotomy was done on all the feet. The results bear out the fact that this procedure is a useful procedure for the management of this disorder.

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Distal, lateral soft tissue release to restore mediolateral balance of the first metatarsophalangeal MTP joint in hallux valgus deformity. Incision of the adductor hallucis tendon from the fibular sesamoid, the lateral capsule, the lateral collateral ligament, and the lateral metatarsosesamoid ligament.

Hallux valgus deformities or recurrent hallux valgus deformities with an incongruent MTP joint. General medical contraindications to surgical interventions. Painful stiffness of the MTP joint, osteonecrosis, congruent joint. Relative contraindications: connective tissue diseases Marfan syndrome, Ehler-Danlos syndrome. Longitudinal, dorsal incision in the first intermetatarsal web space between the first and second MTP joint. Blunt dissection and identification of the adductor hallucis tendon. Release of the adductor tendon from the fibular sesamoid.

Incision of the lateral capsule, the lateral collateral ligament, and the lateral metatarsosesamoid ligament. Postoperative management depends on bony correction. In joint-preserving procedures, dressing for 3 weeks in corrected position. Subsequently hallux valgus orthosis at night and a toe spreader for a further 3 months. Passive mobilization of the first MTP joint.

Postoperative weight-bearing according to the osteotomy. A total of 31 patients with isolated hallux valgus deformity underwent surgery with a Chevron and Akin osteotomy and a distal medial and lateral soft tissue balancing. The mean preoperative intermetatarsal IMA angle was The mean follow-up was There were no.

Maintaining the corrected position of the first metatasophalangeal axis. Reducing postoperative stiffness by forgoing a medial capsular shift.

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Hallux valgus deformities or recurrent hallux valgus deformities. Existing osteoarthritis, joint stiffness, large bone defects, osteonecrosis. General medical contraindications to surgical interventions and anesthesiological procedures. Operation under regional anesthesia foot block or general anesthesia. Longitudinal skin incision medial over the pseudexostosis of the first metatarsal bone. Preparing the tendon of the Musculus abductor hallucis.

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Detaching the tendon from the capsule. Incision of the joint capsule with protection of the extensor hallucis longus tendon and the dorsal neurovascular bundle in an L-wise manner. Osteotomy of the first metatarsal bone. Lax sutures of the capsule in correct position and reattachment of the Musculus abductor hallucis tendon shifted toward distal and dorsal, regarding the rotation of the hallux.

Postoperative elevation of the operated foot. Analgesia with nonsteroidal antiinflammatory drugs. Passive mobilization of the metatarsophalangeal joint. Dressing for 4 weeks postoperatively in the corrected position. Radiologic control after 6 weeks. Hallux valgus orthosis at night and a toe spreader for a further 6 weeks. A total of 30 isolated hallux valgus deformities with a mean preoperative intermetatarsal IMA angle of In this procedure, the dorsal arm of the osteotomy is performed orthogonal to the horizontal plane of the first metatarsal, the main advantage being that this allows much easier and more accurate multiplanar correction of first metatarsal deformities.