Is it feasible to rely on intraoperative X ray in correcting hallux valgus?

NewsBot · Mar 19, 2013

Members do not see these Ads. Sign Up.
Is it feasible to rely on intraoperative X ray in correcting hallux valgus?
Gutteck N, Wohlrab D, Radetzki F, Zeh A, Röllinghoff M, Delank KS, Lebek S.
Arch Orthop Trauma Surg. 2013 Mar 17.

BACKGROUND:
The aim of the study was to prove whether the intraoperatively taken fluoroscopy pictures compared to the X rays taken 8 weeks and 3 months postoperatively picture the achieved correction reliably.

METHOD:
In a prospective study, the pre- and postoperative standing foot X rays as well as the intraoperatively taken fluoroscopy pictures of 31 patients were analysed. The intermetatarsal angle (IMA) and the hallux valgus angle (HVA) were measured. In all cases, a tarso-metatarsal joint I arthrodesis combined with a distal soft tissue release was performed. The mean age was 54 (17-73) years.

RESULTS:
There was no significant difference between the measured angles in intraoperative fluoroscopy and standing X rays postoperatively taken.

CONCLUSIONS:
Despite the consideration that fluoroscopic pictures lack the loading criteria, we found reliable results in IMA and HVA.
Click to expand...

NewsBot · Apr 1, 2014

Can we recreate intraoperative weight bearing in hallux valgus surgery? A radiographic study using a reproducible technique of load bearing to simulate weight bearing
RS Ahluwalia, C Elliott, MS Hennessy, SR Platt
The Foot and Ankle Online Journal 7 (1): 2

Introduction: Correction of the hallux valgus angle, intermetatarsal angle and sesamoid subluxation in hallux valgus surgery is key to restoring normal joint biomechanics. This is difficult to judge accurately intraoperatively as the foot is not weight bearing. We examine the reproducibility of a simulated weight-bearing test on intraoperative images.
Methods: This is a prospective study of 20 patients undergoing a scarf osteotomy for hallux valgus. All patients were operated by one fellowship trained surgeon and were excluded if they had inflammatory arthropathy. At the time of surgery, two intraoperative images were taken after surgical correction. A standard positional anterior posterior (AP) image was taken followed by a reproducible simulated weight bearing view (i.e. load bearing view). A retrospective review of 6 week and 4-6 month weight bearing images was conducted to assess any measurable differences in a separate group of patients.
Results: The mean preoperative HVA was 30.7, IMA was 14.5, sesamoid position was 5.6. On completion of surgical correction the HVA was 6.6, IMA was 7.2 and sesamoid position was 1.8. On simulated weight bearing with an average of 131.2N (range 98.9-163.5N), the HVA was 8.9, IMA was 10.7 and sesamoid position was 2; this was a closer approximation to the 6-week weight bearing view in all indices recorded. No observed difference was noted between 6 week and 3-6 month weight bearing images.
Conclusions: We have found that our standardized simulated load bearing intraoperative view will yield reproducibility and is a good surrogate marker for the 6-week weight-bearing radiograph. We believe locking the ankle joint will avoid rotation of the foot and allow for an accurate evaluation of final correction (HVA, IMA, and sesamoid position) and aid meaningful evaluation of surgical technique. However, it does not represent a final united position therefore we could not recommend its use in isolation.
Click to expand...

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Plantar Fasciitis – A Primary Pathology or Merely a Symptom

Severely displaced fracture 4th & 5th metatarsals

Severely comminuted fracture of the 1st, 2nd, 3rd, 4th, 5th metatarsal bones. 1surgery down, 1to go

Severely cracked heels

Surely someone must be able to diagnose my foot problems?

3 year old with severely pronated foot

Share This Page