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Endolog technique for correction of hallux valgus: a prospective study of 30 patients with 4-year follow-up.

Biz C, Corradin M, Petretta I, Aldegheri R - J Orthop Surg Res (2015)

Bottom Line: The postoperative radiographic assessments showed a statistically significant improvement compared with preoperative values.The mean corrections for each angular value at the last follow-up were as follows: IMA 5.95°; HVA 16.81°; DMAA 10.70°; and tibial sesamoid 1.36°.The Endolog is a safe and effective technique for the correction of HV deformity, to relieve pain and to preserve joint movement.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, via Giustiniani 2, 35128, Padova, Italy. carlo.biz@unipd.it.

ABSTRACT

Background: Hallux valgus (HV) is a complex deformity of the forefoot altering the kinematics of walking. Many different treatment alternatives exist for the correction of hallux valgus, but to date, none has been shown to be more effective than any other. The rate of complications following hallux valgus surgery is variable and has been reported as ranging from 1 to 55 % in the scientific literature. The purpose of this preliminary prospective study was to evaluate the result of the Endolog device, an innovative titanium endomedullary nail, for the treatment of HV.

Methods: Thirty patients with mild-to-severe HV were treated with the Endolog device. Clinical evaluation was assessed preoperatively, as well as at 3, 6, 12, 24, and 48 months after surgery with a final follow-up at 4 years, using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux grading system. Computer-assisted measurement of weight-bearing antero-posterior radiographs was taken preoperatively and postoperatively, as well as at 3, 6, 12, 24, and 48 months after surgery. Non-weight-bearing radiographs were taken before the patients were discharged. The radiological parameters measured included the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA), and the tibial sesamoid position. Statistical analysis was carried out using the paired t test (p < 0.05).

Results: The mean AOFAS score was 93.98 points at the 48-month follow-up. The postoperative radiographic assessments showed a statistically significant improvement compared with preoperative values. The mean corrections for each angular value at the last follow-up were as follows: IMA 5.95°; HVA 16.81°; DMAA 10.70°; and tibial sesamoid 1.36°.

Conclusion: The Endolog is a safe and effective technique for the correction of HV deformity, to relieve pain and to preserve joint movement.

No MeSH data available.


Related in: MedlinePlus

Case 12. A 71-year-old woman with moderate HV. a Preoperative lateral radiographic image. b At 1-month follow-up, lateral X-ray image. c Radiographic aspect at 48-month follow-up showing the maintained correction of the deformity and complete healing of the osteotomy. d X-ray image, sesamoid axial view, at 48-month follow-up
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Fig18: Case 12. A 71-year-old woman with moderate HV. a Preoperative lateral radiographic image. b At 1-month follow-up, lateral X-ray image. c Radiographic aspect at 48-month follow-up showing the maintained correction of the deformity and complete healing of the osteotomy. d X-ray image, sesamoid axial view, at 48-month follow-up

Mentions: Regarding complications, there were no cases of superficial wound infection, cellulitis, osteomyelitis, or postoperative lesser transfer metatarsalgia. None of the 30 patients experienced postoperative avascular necrosis of the first metatarsal head. We did not encounter any recurrence of deformity, hallux varus due to overcorrection, malunion, delayed union, non-union, residual pain, or irritation from internal fixation by the device (Fig. 18). None of the first 30 implants was removed after the 4 year follow-up.Fig. 18


Endolog technique for correction of hallux valgus: a prospective study of 30 patients with 4-year follow-up.

Biz C, Corradin M, Petretta I, Aldegheri R - J Orthop Surg Res (2015)

Case 12. A 71-year-old woman with moderate HV. a Preoperative lateral radiographic image. b At 1-month follow-up, lateral X-ray image. c Radiographic aspect at 48-month follow-up showing the maintained correction of the deformity and complete healing of the osteotomy. d X-ray image, sesamoid axial view, at 48-month follow-up
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4492074&req=5

Fig18: Case 12. A 71-year-old woman with moderate HV. a Preoperative lateral radiographic image. b At 1-month follow-up, lateral X-ray image. c Radiographic aspect at 48-month follow-up showing the maintained correction of the deformity and complete healing of the osteotomy. d X-ray image, sesamoid axial view, at 48-month follow-up
Mentions: Regarding complications, there were no cases of superficial wound infection, cellulitis, osteomyelitis, or postoperative lesser transfer metatarsalgia. None of the 30 patients experienced postoperative avascular necrosis of the first metatarsal head. We did not encounter any recurrence of deformity, hallux varus due to overcorrection, malunion, delayed union, non-union, residual pain, or irritation from internal fixation by the device (Fig. 18). None of the first 30 implants was removed after the 4 year follow-up.Fig. 18

Bottom Line: The postoperative radiographic assessments showed a statistically significant improvement compared with preoperative values.The mean corrections for each angular value at the last follow-up were as follows: IMA 5.95°; HVA 16.81°; DMAA 10.70°; and tibial sesamoid 1.36°.The Endolog is a safe and effective technique for the correction of HV deformity, to relieve pain and to preserve joint movement.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, via Giustiniani 2, 35128, Padova, Italy. carlo.biz@unipd.it.

ABSTRACT

Background: Hallux valgus (HV) is a complex deformity of the forefoot altering the kinematics of walking. Many different treatment alternatives exist for the correction of hallux valgus, but to date, none has been shown to be more effective than any other. The rate of complications following hallux valgus surgery is variable and has been reported as ranging from 1 to 55 % in the scientific literature. The purpose of this preliminary prospective study was to evaluate the result of the Endolog device, an innovative titanium endomedullary nail, for the treatment of HV.

Methods: Thirty patients with mild-to-severe HV were treated with the Endolog device. Clinical evaluation was assessed preoperatively, as well as at 3, 6, 12, 24, and 48 months after surgery with a final follow-up at 4 years, using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux grading system. Computer-assisted measurement of weight-bearing antero-posterior radiographs was taken preoperatively and postoperatively, as well as at 3, 6, 12, 24, and 48 months after surgery. Non-weight-bearing radiographs were taken before the patients were discharged. The radiological parameters measured included the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA), and the tibial sesamoid position. Statistical analysis was carried out using the paired t test (p < 0.05).

Results: The mean AOFAS score was 93.98 points at the 48-month follow-up. The postoperative radiographic assessments showed a statistically significant improvement compared with preoperative values. The mean corrections for each angular value at the last follow-up were as follows: IMA 5.95°; HVA 16.81°; DMAA 10.70°; and tibial sesamoid 1.36°.

Conclusion: The Endolog is a safe and effective technique for the correction of HV deformity, to relieve pain and to preserve joint movement.

No MeSH data available.


Related in: MedlinePlus