Immediate full weight bearing after tarsometata arthrodesis in correcting severe hallux valgus deformity - is it achievable?

Transcription

1 Immediate full weight bearing after tarsometata arthrodesis in correcting severe hallux valgus deformity - is it achievable? Burg Giebichenstein. KunstHochschule Halle Leopoldina

2 Presentation title: Immediate full weight bearing after tarsometatarsal arthrodesis in correcting severe hallux valgus deformity - is it achievable? Presenters name: N. Gutteck MD My disclosure is in the final AOFAS program book. I have no potential conflicts with this presentation. N. Gutteck MD

3 Background: - The arthrodesis of the tarso-metatarsal joint I (TMTI) is an established method of treating a hallux valgus especially with a joint pathology (1, 2, 3). - Thus far, TMT-I arthrodesis is associated with a high psodarthrosisrate up to 20% (1, 4, 5) - The most authors advise a partial weight bearing for several weeks - The immobilisation requires often a longsome treatment till full weight bearing is achieved - In a prospective study results after plantar osteosynthesis with two different treatments after surgery concerning undesirable effects were compared.

4 Material und Methods: -In a prospective study 40 patients were included for TMT-I arthrodesis using a DARCO plantar Lapidus plate (Wright, Raisting, Germany). -20 patients (14 women, 6 men, 52 (17-72) years): partial weight bearing with 20 kg in a special shoe (Vacopedes ) -20 patients (16 women, 4 men, 56 (23-72) years): immediate full weight bearing in a special shoe (Vacopedes ) -Undesirable effects were analysed: Delayed bone healing, pseudarthrosis, conflict with material, elevation of the first metatarsal bone, metatarsalgia, insufficient correction of the intermetatarsal angle and wound healing complication oped GmbH Germany

5 Material und Methods: - The AOFAS-Score, VAS and radiological examination in standing position were done preoperatively, 6 weeks and 1 year postoperatively.

6 Results: - No significant difference between the groups - No significant difference in the achieved correction 6 weeks and 1 year postoperatively in both groups

7 Conclusion: - The TMT I arthrodesis shows a high correction potential in treating hallux valgus (4). - The immediate full weight bearing after plantar TMT-I arthrodesis did not lead to higher rate of undesirable effects - Pseudarthrosis, conflict with material, elevation of the first metatarsal bone, metatarsalgia, insufficient correction of the intermetatarsal angle and wound healing complication were not observed in both groups

8 Is it feasible to rely on intraoperative X ray in correcting hallux valgus? References: 1.Leventen EO. The Chevron procedure. Orthopaedics 1990; 13: Coetzee JC, Wickum D. The Lapidus procedure: a prospective cohort outcome study. Foot Ankle Int 2004; 25: Neylon TA, Johnson BA, Laroche RA. Use of the Lapidus bunionectomy in first ray insufficiency. Clin Podiatr Med Surg 2001; 18: Myerson MS, Schon LC, McGuigan FX, Oznur A (2000) Results of arthrodesis oft he hallux metatarsophalangeal joint using bone graft for restoration of length. Foot Ankle Int 21: Neylon TA, Johnson BA, Laroche RA (2001) Use of the lapidus bunionectomie in first ray insufficiency, Clin Podiatr Med Surg 18:

9 Thank you Burg Giebichenstein. KunstHochschule Halle Leopoldina N. Gutteck MD