i have a 70 year old,moderately active patient presenting for hallux valgus correction.his medical history is umremarkable.the deformity can be summed up as follows: HA angle 35,pasa 8,HIA 10,ima of 18,with no evidence djd and no shortening of the metatarsal.my dilemma is in deciding whether this patient could be better served with a base wedge osteotomy,along with a distal soft tissue correction.
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i am also debating as to the possibility of an austin with possibly a distal akin(although i realize the cut off on the ima is 16);or possible a reverdin-green-liard osteotomy and the akin.i just don't feel this patient would do well with the post-op rigors of a base wedge.
any suggestions from other colleagues would be helpful.
rick
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