Abstract

YANEZ ARAUZ, Juan Manuel et al. Osteotomía percutánea de la falange distal del hallux. Indicaciones y técnica. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2021, vol.86, n.2, pp.139-150. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2021.86.2.1097.

Introduction: There are many techniques to correct the hallux deformity. Most of them include metatarsal and/or phalanx osteotomies. 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 However, indications for the distal phalanx osteotomy remain unpublished.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 measurements 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.

Keywords : Phalangeal osteotomy; percutaneous surgery; hallux valgus; hallux deformity; MIS osteotomy.

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