Hallux Valgus - Surgical Treatment et corrections des oignons



Surgical Treatment Guidance Before Surgery Regional Aenesthesia Post-Surgery Guidance General complications Specific Complications Pronosis Watch your feet!		Surgical Treatment Introduction Several factors have to be considered for surgery that will both be efficient, and lower the prospect of recurrence. Clinical Stage Age of patient at onset Degree of deviation of the big toe (i.e. : the Hallux Valgus angle) Angle between the 1st and 2nd metatarsals Comparative lengths of the 1st and 2nd metatarsals Incline of the 1st metatarsal head (DMAA) and its specific anatomy Sagging of the 2nd (or 2nd and 3rd) metatarsals (i.e.: MTP subluxation) Other associated deformations (hammer toes, tailor’s bunion, Heloma Dura (i.e. : corns), etc. Osteoarthritis, arthritis. Hypermobility of the 1st ray (ligamentary hyperlaxity) Hallux Valgus surgery has long been infamous and justly so! More often than not, this was caused by bad procedures, or a good surgery on the wrong patient. Many surgeons will use the same procedure on all their patients! Others do not ask for a pre-op X-ray!...be aware and leave... One must pick out the most appropriate procedure for the patient’s case. For instance, rarely can a Hallux Valgus be corrected without having to saw the bone and place it back where it belongs (osteotomy). This is rarely done nowadays. This procedure is called McBride’s and associates exostectomy (i.e.the slight filing of the bony bulge), and section of the adductor tendon, and recapsuloraphy. In old days, removal of the lateral sesamoid bone was associated with a very high incidence of Hallux varus ( the reverse deformation)

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Surgical Treatment

Introduction