Kramer osteotomy for hallux valgus

NewsBot · Aug 1, 2016

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Short- and long-term outcomes following hallux-valgus correction: a modified Kramer osteotomy.
Christoph K et al
Arch Orthop Trauma Surg. 2016 Jul 30

BACKGROUND:
Short- and long-term assessments were performed of a modification to the Kramer osteotomy that developed to stabilize the metatarsal head using an angular implant, the LINK? internal hallux fixator (Waldemar LINK GmbH & Co. KG, Hamburg, Germany).
METHODS:
For this retrospective study, radiological assessments were used to measure outcomes in 72 feet with hallux valgus treated from 2006 to 2011. The hallux-valgus angle, the intermetatarsal angle between the first and second intermetarsal shaft axes, and the distal metatarsal articular angle were measured at short- and long-term intervals. Long-term clinical assessments included results of the Foot Function Index and the American Orthopedic Foot and Ankle Society Forefoot Score.
RESULTS:
Of the 72 feet treated, 12 were done as bilateral operations. Fifty-five patients at a mean age of 52 years (?12; range 22-78) were included in short-term assessments. Significant improvements in angular measurements were made (p < 0.001) between baseline and 3 month assessments. Three postoperative complications occurred and 40 % (29/72) of the implants were eventually removed. Fifty-five of the 72 feet were available for long-term assessments at a median of 5 years postoperatively (IQR 5-7; range 3-9). No significant loss of correction was detected (p = 0.373). Clinical assessments indicated successful outcomes in 86 % (47/55) of the feet, with slightly better results in older patients (p = 0.033; OR 1.1, CI 95 % 1.01-1.15).
CONCLUSION:
This technique can achieve normal angular configuration, even with severe deformities, without significant long-term loss of correction. Patients should be informed of potential discomfort necessitating hardware removal, although the likelihood of complications is low.
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NewsBot · Feb 22, 2021

Reintervention rates following hallux valgus correction with the original and a
modified Kramer osteotomy
Christoph Knoth, et al
Acta Orthop. Belg., 2020, 86 e-supplement 2, 87-95

Numerous surgical techniques to correct hallux
valgus deformities are performed worldwide, some of
which were developed to address problems associated
with existing techniques.
This retrospective study investigated patient’s
outcomes and reintervention rates following the
original Kramer osteotomy (KO) and a modified
version of the KO (MKO). Results of radiological and
clinical were gathered from medical records and longterm follow-up visits.
Angular measurements significantly improved
and only three minor postoperative complications
occurred after both procedures. No significant loss of
correction was detected at long-term follow-up. The
reintervention rate in the MKO group was 53% and
the malalignment rate in the KO group was 18%.
Despite promising angular results, both techniques
had important weaknesses. MKO had a high
reintervention rate, which was even more clinically
problematic than malalignment after KO. Given
the vast array of surgical techniques to treat this
condition, we conclude that better performing options
should be considered.
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