A study was performed to assess the possible increase in the intraoperative interphalangeal angle (HIA) following basilar first metatarsal osteotomy and distal soft tissue realignment for hallux valgus (HV) correction. It also assessed the efficacy of an additional Akin osteotomy (AO). The study involved 54 feet with moderate to severe HV. HIAs and medial sesamoid subluxations (MSS) were quantified pre- and intra-operatively. An intraoperative measurement was used to assess the need for additional AO, based on the incongruency of the metatarsophalangeal joint (MTPJ). Following the DTSP and PCMO procedures, HIAs increased from an average of 9 to 13.3 degrees and MSS reduced from average grade 2.5 to 0.5. AO was added in 44 feet.
After a mean followup of 13.2 months in the Akin group, average VAS pain score declined from 5.7 to 1.2 and average AOFAS score improved from 57.8 to 90.2. Final hallux MTPJ dorsiflexion in the Akin group was significantly larger than in the without-Akin group (p < 0.05).
From the article of the same title
Foot & Ankle International (10/11) Vol. 32, No. 10, Park, Jae-Yong
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About drphilipw
Dr. Philip Wrotslavsky specializes in the diagnosis and treatment of infant, children and adult patients with medical conditions of the foot, ankle and lower leg structures.
Dr Wrotslavsky completed his orthopedic fellowship (Chief Fellow) at The Limb Reconstruction Fellowship Program at the International Center for Limb Lengthening in Baltimore, Maryland under the guidance of Dr. Dror Paley and Dr. John Herzenberg. His fellowship experience included the in-depth study, prevention, and treatment of limb threatening foot conditions, infections, diabetic charcot neuroarthropathy, nonunions, malunions, and congenital and posttraumatic limb deformities. He has adopted techniques derived from the science of distraction osteogenesis.He is adept at utilizing the full gamut of orthopedic fixation materials, including screws, wires, plates, intramedullary rods, and monolateral and circular fixators (Ilizarov and Taylor Spatial Frame) in the treatment and correction of deformities.
His 4 years of podiatry foot and ankle surgical residency training took place in an inner city hospital in New York City, where he worked with a multidisciplinary team of general, podiatric, orthopedic and vascular physicians and surgeons and provided a wide variety of foot and ankle care including wound care, ankle arthroscopy, diabetic limb salvage and reconstruction, flatfoot reconstruction, neurological cavo-varus foot reconstruction and management of trauma to the foot and ankle.
Dr Wrotslavsky's fellowship and residency training has taught him to perform a full biomechanical exam identifying lower extremity pathology from spine to foot.He enjoys working with a team of physicians identifying the patients’ pathology and providing the appropriate treatment.
