+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Proximal oblique sliding closing wedge osteotomy for hallux valgus

Proximal oblique sliding closing wedge osteotomy for hallux valgus

Foot and Ankle International 34(11): 1493-1500

The proximal oblique sliding closing wedge osteotomy (POSCOW) technique was developed to address moderate to severe hallux valgus deformity. We present a retrospective multicenter study to analyze the midterm radiological and clinical outcomes of patients treated with this type of proximal osteotomy fixed with plates. One hundred and forty-four patients (187 feet) were operated on between May 2005 and June 2010 in 2 separate centers. Inclusion criteria were symptomatic moderate to severe incongruent hallux valgus deformity, no significant restriction in the first metatarsophalangeal joint movement, none to minimal degenerative changes in the first metatarsophalangeal or the tarsometatarsal joints, and no hypermobility. The median age was 60 years. The preoperative hallux valgus angle (HV) was 35.6 degrees, intermetatarsal angle (IM) was 15.3 degrees, AOFAS score was 53 points. The median follow-up was 35 months (range, 12-73). A POSCOW osteotomy was performed in all patients and fixed with plates. We recorded the satisfaction rate, postoperative clinical and radiological results, and complications. The patient satisfaction rate was 87%. The mean postoperative HV angle was 12.3 degrees, IM angle 4.8 degrees, AOFAS score 89 points. The mean decrease in the first metatarsal length was 2.2 mm (range, 0-8). Twelve feet (6.4%) with recurrence of the deformity required revision surgeries. Removal of complete or partial hardware was needed in 23 feet (12.3%) for symptomatic hardware. Five feet (2.6%) developed hallux varus but only 2 required surgery. Transfer metatarsalgia was noted in 9 feet (4.8%). The POSCOW osteotomy was an effective and reliable method for relieving pain and improving function. A learning curve was present, as most of the complications happened in the initial cases. To our knowledge, this is the largest reported series of proximal closing wedge osteotomy for hallux valgus deformities. Level IV, case series.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 036981251

Download citation: RISBibTeXText

PMID: 23863313

DOI: 10.1177/1071100713497933

Related references

Proximal Oblique Slide Closing Wedge Metatarsal Osteotomy With Plate Fixation for Severe Hallux Valgus Deformities. Techniques in Foot & Ankle Surgery 6(4): 270-274, 2007

First metatarsal proximal opening wedge osteotomy for correction of hallux valgus deformity: comparison of straight versus oblique osteotomy. Yonsei Medical Journal 56(3): 744-752, 2015

Effectiveness of Percutaneous Proximal Closing Wedge Osteotomy With Akin Osteotomy to Correct Severe Hallux Valgus Determined by Radiographic Parameters. Foot and Ankle Specialist 10(2): 170-179, 2017

Scarf versus proximal closing wedge osteotomy in hallux valgus treatment. Archives of Orthopaedic and Trauma Surgery 129(10): 1347-1352, 2009

Proximal closing wedge osteotomy and adductor tenotomy for treatment of hallux valgus. Foot and Ankle 10(3): 191, 1989

Biplanar Oblique Closing Wedge Osteotomy of the Hallux Proximal Phalanx With Screw Fixation. Techniques in Foot & Ankle Surgery 8(3): 155-158, 2009

Proximal opening wedge osteotomy with wedge-plate fixation compared with proximal chevron osteotomy for the treatment of hallux valgus: a prospective, randomized study. Journal of Bone and Joint Surgery. American Volume 96(19): 1585-1592, 2014

Sliding oblique osteotomy for the treatment of hallux abducto valgus associated with functional hallux limitus. Journal of Foot and Ankle Surgery 39(3): 161-167, 2000

The Closing Base Wedge Osteotomy for Severe Hallux Valgus. Techniques in Foot & Ankle Surgery 6(3): 175-184, 2007

Rates of revision surgery using Chevron-Austin osteotomy, Lapidus arthrodesis, and closing base wedge osteotomy for correction of hallux valgus deformity. Journal of Foot and Ankle Surgery 47(4): 267-272, 2008

First metatarsal length change after basilar closing wedge osteotomy for hallux valgus. Foot and Ankle International 32(5): S513-S518, 2011

Proximal Opening Wedge Osteotomy With Distal Chevron Osteotomy of the First Metatarsal for the Treatment of Moderate to Severe Hallux Valgus. Foot and Ankle International 40(1): 89-97, 2019

Proximal oblique crescentic osteotomy in hallux valgus. Journal of the American Podiatric Medical Association 94(1): 43-46, 2004

A radiographic evaluation of oblique closing base wedge osteotomies for the correction of hallux abductus valgus. Foot 8(1): 33-37, 1998

The Akin procedure as closing wedge osteotomy for the correction of a hallux valgus interphalangeus deformity. Operative Orthopadie und Traumatologie 20(6): 477-483, 2008