DOS 2018

DOS Kongressen 2018 · 217 Correction of 1st MTP-joint arthrodesis with a bow-shaped osteotomy Marianne Toft Vestermark, Andrius Kazlauskas Department of Orthopaedic Surgery, Central Jutland Regional Hospital, Viborg; Department of Orthopaedic Surgery, Aalborg University Hospital Background: Arthrodesis of the 1st MTP-joint is most commonly performed on the basis of sever Hallux Ridigus The MTP-joint is positioned in 10-20 degrees dorsiflexion and 10 degrees valgus in order ease ambulation. Overcorrection into hyper dorsiflexion is a known complication but correction is not well de- scribed in the literature. Purpose / Aim of Study: Present a technique for correction of hyper dorsi- flexed MTP-1 arthrodesis. Materials and Methods: A right MTP-1 joint was fused due to sever hallux ridigus. The primary surgery was uneventful until transferred into normal shoes at 6 weeks. Complains were of impingement pain with the toe-box of the shoes dorsomedially over the Interphalangeal joint of the first toe and plantar under the caput first metatarsus. In standing position, the MTP-1 joint was both clini- cally and radiographically in hyper dorsiflexion and with full plantarflexion over the IP joint the toe had no contact with the ground. Conservative treatment with costume-made orthosis and use of shoes with spacious toe-box was un- satisfactory. Operative correction was performed with a V-shaped osteotomy tilted proximally from dorsum to the plantar of the first toe-ray like the front bow of a ship. When the toe was slided downward the tip was further moved plantar. Shortening of the toe was hereby minimized. The osteotomy was fix- ated with two crossing screws. Findings / Results: The surgery as well as the post-operative treatment was uneventful. The patient was greatly relieved by the correction and was 6 weeks post-operatively transferred to ordinary shoes. The bow-shaped osteotomy for correction reduced the dorsiflexion of the toe from 46 degrees to 33 degrees. Conclusions: A bow-shaped osteotomy was successful in correction of pri- mary hyper dorsiflexed arthrodesis of the 1st MTP-joint. 158.