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The results of hallux valgus treated by modified Mitchell osteotomy with one screw fixation
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Abstracts from the 6th IFFAS Triennial Meeting / Foot and Ankle Surgery 23(S1) (2017) 29–154
ously symptom-free trauma patients (n = 10) were used as controls. For the position of adjacent two bones, the distance between articular surfaces was computationally calculated using the angle weighted pseudonormal technique. For the alignment of the adjacent two bones, its normalized articular surface orientation was calculated and alignment was assessed by the angle between two articular surfaces. For comparison, data from WB and NWB CT scans and data from normal subjects and patients were compared, respectively. Results: By 3D computational analysis, the distance between adjacent bones could be presented by distance map and average distance. The average distance between TNJ and PTCJ was lower in WB than NWB in all participants and well demonstrated by distance map. Also In comparison between normal subjects and patients, patients had a lower value of average distance between joints than normal subjects. The alignment of joint was also found different between WB and NWB and between normal subjects and patients, respectively, both in TNJ and PTCJ. Conclusion: Our results show that 3D analysis technique using articular surface might be useful to assess changes in alignment of the tarsal bones and that the information of WB CT was substantially different from that of NWB CT in the same subject. http://dx.doi.org/10.1016/j.fas.2017.07.304
216 Comparison of foot and ankle measurement between healthy young and older adults in standing X-ray E.J. Kim 1,∗ , D.Y. Lee 2 , D.J. Lee 2 , K.M. Lee 3 , S.G. Seo 4 1
Hanil General Hospital, South Korea Seoul National University Hospital, South Korea 3 Seoul National University Bundang Hospital, South Korea 4 Asan Medical Center, South Korea 2
Introduction: The purpose of this study is both (1) figuring out radiographic reference value according to aging and (2) comparison between young and older adults of the foot and ankle radiographic measurements in the large number of healthy people. Methods: One hundred feet of 100 healthy young adults (50 males, 50 females) with 20–35 years old and one hundred feet of 100 healthy older adults (50 males, 50 females) with 60–69 years old were examined. Weight bearing full leg radiograph, foot anetro-posterior and lateral view radiographs were performed. AP tibiotalar angle, talar tilt, calcaneal pitch, lateral tibiocalcaneal angle, lateral talcocalcaneal angle, cavus ratio, naviculocuboid overlab, and talonavicular coverage angle was measured. AP and lateral talo-first metatarsal angles, metatarsal stacking angle, hallux valgus angle and hallux interphalangeal angle were measured. Results: In comparison of young adults, hallux valgus angle in female and cavus ratio in male were significantly higher. In comparison of older adults, lateral talo-1st metatarsal angle, and lateral talocalcaneal angle were significantly larger in older male. With aging, hallux valgus angle, hallux interphalangeal angle, calcaneal pitch and lateral talo-1st metatarsal angle in male showed significantly different. In female, hallux valgus angle and cavus ratio were changed with getting older. Discussion: We figured out the reference values of the foot and ankle radiographic measurement with aging in large volume of healthy people. The results showed the difference values in accor-
dance with age and gender. This study can be applicable to evaluate the foot and ankle disease as providing the fundamental data. http://dx.doi.org/10.1016/j.fas.2017.07.305
217 The results of hallux valgus treated by modified Mitchell osteotomy with one screw fixation S.J. Chen 1,2,∗ , P.J. Huang 1,2 , Y.M. Cheng 1,2 1
Department of Orthopaedics, Kaohsiung Medical University Hospital, Taiwan 2 Department of Orthopaedics, Pingtung Hospital, Taiwan Introduction: We had performed more than 1500 cases of a Modified Mitchell osteotomy and traditionally crossed pins for fixation. However, complications related to pin tract infection and pin migration were noted. Since 2009, we used a compression screw for fixation, instead of crossed pins. Now, we retrospectively reviewed the cases and reported the results. Method: We retrospectively reviewed patients with hallux valgus treated by modified Mitchell osteotomy with a compression screw. Standing foot AP and LAT views were performed pre-operatively and more than 6 months post-operatively. Weightbearing hallux valgus (HV) angle and inter-metatarsal (IM) angle were measured. Result: From 2010/01/01 to 2014/12/31, 434 ft were finally enrolled. The average pre-op HV angle was 35.3◦ and IM angle was 14.4◦ . After at least 6 months follow-up, the average post-op HV angle was 12.8◦ and IM angle was 6.7◦ . Among the 434 ft, the post-op HV angle of 39 ft were more than 20◦ and were defined as recurrence (recurrent rate of HV angle was 9%). Besides, we found that pre-operative HV angle is the predictive factor of recurrence. Conclusion: According to the result, one compressive screw fixation was a good method for modified Mitchell osteotomy for hallux valgus. The recurrent rate of HV angle was low (less than 10%) and no obvious wound infection was found. Besides, the preoperative HV > 39.5◦ is the cut-off point of recurrence. http://dx.doi.org/10.1016/j.fas.2017.07.306
218 2–5 year results after minimally invasive reconstruction of the Achilles tendon with semitendinosus H. Thermann HKF – International Center for Hip, Knee and Foot Surgery, ATOS Clinic Heidelberg, Germany Introduction: Defect situation after Achilles tendon rupture is caused by neglected acute rupture and resection after revision Achilles tendon surgery. The study evaluates the outcome following reconstruction defect situation after Achilles tendon ruptures/surgeries using free Semitendinosus tendon (Semi-T) graft transfer in endoscopic assisted technique. Methods: Twenty-six patients (8 female, 18 male) underwent Achilles tendon repair with free Semi-T graft transfer. Results were assessed using VAS score for pain, function and satisfaction and VISA-A score at Baseline and follow-up and strength test for dorsal extension (DE) and plantar flexion (PF) only postoperatively. Results: The mean age of the patients was 57.5 ± 14.1 years (32–75) and mean BMI was 25.7 ± 2.4 (22.7–29.4). The average
Abstracts from the 6th IFFAS Triennial Meeting / Foot and Ankle Surgery 23(S1) (2017) 29–154
ously symptom-free trauma patients (n = 10) were used as controls. For the position of adjacent two bones, the distance between articular surfaces was computationally calculated using the angle weighted pseudonormal technique. For the alignment of the adjacent two bones, its normalized articular surface orientation was calculated and alignment was assessed by the angle between two articular surfaces. For comparison, data from WB and NWB CT scans and data from normal subjects and patients were compared, respectively. Results: By 3D computational analysis, the distance between adjacent bones could be presented by distance map and average distance. The average distance between TNJ and PTCJ was lower in WB than NWB in all participants and well demonstrated by distance map. Also In comparison between normal subjects and patients, patients had a lower value of average distance between joints than normal subjects. The alignment of joint was also found different between WB and NWB and between normal subjects and patients, respectively, both in TNJ and PTCJ. Conclusion: Our results show that 3D analysis technique using articular surface might be useful to assess changes in alignment of the tarsal bones and that the information of WB CT was substantially different from that of NWB CT in the same subject. http://dx.doi.org/10.1016/j.fas.2017.07.304
216 Comparison of foot and ankle measurement between healthy young and older adults in standing X-ray E.J. Kim 1,∗ , D.Y. Lee 2 , D.J. Lee 2 , K.M. Lee 3 , S.G. Seo 4 1
Hanil General Hospital, South Korea Seoul National University Hospital, South Korea 3 Seoul National University Bundang Hospital, South Korea 4 Asan Medical Center, South Korea 2
Introduction: The purpose of this study is both (1) figuring out radiographic reference value according to aging and (2) comparison between young and older adults of the foot and ankle radiographic measurements in the large number of healthy people. Methods: One hundred feet of 100 healthy young adults (50 males, 50 females) with 20–35 years old and one hundred feet of 100 healthy older adults (50 males, 50 females) with 60–69 years old were examined. Weight bearing full leg radiograph, foot anetro-posterior and lateral view radiographs were performed. AP tibiotalar angle, talar tilt, calcaneal pitch, lateral tibiocalcaneal angle, lateral talcocalcaneal angle, cavus ratio, naviculocuboid overlab, and talonavicular coverage angle was measured. AP and lateral talo-first metatarsal angles, metatarsal stacking angle, hallux valgus angle and hallux interphalangeal angle were measured. Results: In comparison of young adults, hallux valgus angle in female and cavus ratio in male were significantly higher. In comparison of older adults, lateral talo-1st metatarsal angle, and lateral talocalcaneal angle were significantly larger in older male. With aging, hallux valgus angle, hallux interphalangeal angle, calcaneal pitch and lateral talo-1st metatarsal angle in male showed significantly different. In female, hallux valgus angle and cavus ratio were changed with getting older. Discussion: We figured out the reference values of the foot and ankle radiographic measurement with aging in large volume of healthy people. The results showed the difference values in accor-
dance with age and gender. This study can be applicable to evaluate the foot and ankle disease as providing the fundamental data. http://dx.doi.org/10.1016/j.fas.2017.07.305
217 The results of hallux valgus treated by modified Mitchell osteotomy with one screw fixation S.J. Chen 1,2,∗ , P.J. Huang 1,2 , Y.M. Cheng 1,2 1
Department of Orthopaedics, Kaohsiung Medical University Hospital, Taiwan 2 Department of Orthopaedics, Pingtung Hospital, Taiwan Introduction: We had performed more than 1500 cases of a Modified Mitchell osteotomy and traditionally crossed pins for fixation. However, complications related to pin tract infection and pin migration were noted. Since 2009, we used a compression screw for fixation, instead of crossed pins. Now, we retrospectively reviewed the cases and reported the results. Method: We retrospectively reviewed patients with hallux valgus treated by modified Mitchell osteotomy with a compression screw. Standing foot AP and LAT views were performed pre-operatively and more than 6 months post-operatively. Weightbearing hallux valgus (HV) angle and inter-metatarsal (IM) angle were measured. Result: From 2010/01/01 to 2014/12/31, 434 ft were finally enrolled. The average pre-op HV angle was 35.3◦ and IM angle was 14.4◦ . After at least 6 months follow-up, the average post-op HV angle was 12.8◦ and IM angle was 6.7◦ . Among the 434 ft, the post-op HV angle of 39 ft were more than 20◦ and were defined as recurrence (recurrent rate of HV angle was 9%). Besides, we found that pre-operative HV angle is the predictive factor of recurrence. Conclusion: According to the result, one compressive screw fixation was a good method for modified Mitchell osteotomy for hallux valgus. The recurrent rate of HV angle was low (less than 10%) and no obvious wound infection was found. Besides, the preoperative HV > 39.5◦ is the cut-off point of recurrence. http://dx.doi.org/10.1016/j.fas.2017.07.306
218 2–5 year results after minimally invasive reconstruction of the Achilles tendon with semitendinosus H. Thermann HKF – International Center for Hip, Knee and Foot Surgery, ATOS Clinic Heidelberg, Germany Introduction: Defect situation after Achilles tendon rupture is caused by neglected acute rupture and resection after revision Achilles tendon surgery. The study evaluates the outcome following reconstruction defect situation after Achilles tendon ruptures/surgeries using free Semitendinosus tendon (Semi-T) graft transfer in endoscopic assisted technique. Methods: Twenty-six patients (8 female, 18 male) underwent Achilles tendon repair with free Semi-T graft transfer. Results were assessed using VAS score for pain, function and satisfaction and VISA-A score at Baseline and follow-up and strength test for dorsal extension (DE) and plantar flexion (PF) only postoperatively. Results: The mean age of the patients was 57.5 ± 14.1 years (32–75) and mean BMI was 25.7 ± 2.4 (22.7–29.4). The average