Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi University, Turkey
Approval Date: 2018
Thesis Language: Turkish
Student: Ahmet Yiğit Kaptan
Supervisor: ALİ TURGAY ÇAVUŞOĞLUAbstract:
Hallux valgus is a common foot deformity which affects the life quality of patients. The most common expectations of patients are pain free shoe wearing and working. Despite the radiographic findings of different methods are satisfactory for the surgeon, wearing shoes without pain, which is the most important expectation of the patients, is often not met. In the present study, we retrospectively assessed the clinical and radiological results of distal metatarsal oblique osteotomy as well as forefoot narrowing, plantar aponeurosis loosening and shortening of the first metatarsal. 22 patients (26 feet) who underwent distal metatarsal oblique osteotomy in Gazi University Faculty of Medicine Department of Orthopedics and Traumatology between 2012-2015 with the diagnosis of hallux valgus were included in the present study. The American Orthopedic Foot and Ankle Society (AOFAS)-the Halluks Metatarsofalangeal-Interfalangeal Scale were used in the clinical evaluation. HVA, DMAA, IMA, forefoot bone tissue and soft tissue width and 1.metatarsal length measured on the weightbearing anterior-posterior foot Xray. The mean HVA decreased from 36.2° to 20.1°, IMA from 15.1° to 9.5°, DMAA from 16.2° to 7.4 ° . The mean bone tissue width of the forefoot decreased from 9.4 cm to 8.8 cm after surgery. The mean 1.metatarsal length decreased from 5.8 cm to 5.3 cm after surgery. HVA, IMA, DMAA, anteroposterior bone tissue width and shortening of the first metatarsal showed a statistically significant decrease (p <0,05). The AOFAS Hallux Metatarsofalangeal-Interphalangeal Scale improved from 41,27 to 84,96. AOFAS Hallux Metatarsophalengeal- Interphalengeal Scale footwear requirement part improved from 3.58 to 9.04 after surgery. The most important indicators of a successful hallux valgus surgery for satisfaction of patients are pain-free walking and reduce restriction shoes preference freely. Distal metatarsal oblique osteotomy provides forefoot narrowing and as a result patients are able to wear shoes without pain. Transverse metatarsalgia that may occur with the shortening of the 1.metatarsal shortening can be prevented by appropriate sesamoid reduction and plantar fixation of the distal part. Plantar pressure analyzes performed before and after the operation of the patient who will undergo distal metatarsal oblique osteotomy in the following period will reveal the effect of this method as it demonstrates pressure change in the plantar region.