Plantar pressure distribution and pain after distal osteotomy for hallux valgus

Abstract Background Elevated pressure under the central forefoot region is common in hallux valgus and this is often associated with metatarsalgia. Objective To ascertain whether there was a difference in pain and plantar pressure distribution parameters after correction of the deformity by two distal metatarsal osteotomy techniques. Methods Twenty-two patients randomly assigned to distal chevron or Lindgren first metatarsal osteotomy were evaluated prospectively with dynamic plantar pressure measurement, quality of life scores and clinical and radiographic measurements. Data were collected pre-operatively, at 6 and 12 months after surgery. Results of the combined operated group were compared with an age-matched control group. Results There were no significant differences in plantar pressure distribution parameters between the two operated groups at any occasion. At 6 months peak pressure was significantly less under the lateral forefoot in the operated feet compared with the non-operated feet and significantly greater under the central forefoot than in the control group and the medial forefoot than under the non-operated feet, although the operated group had normalised after 12 months. The visual analogue scale (VAS) showed significant improvements after both surgical techniques. Conclusion Both surgical techniques resulted in significant clinical and radiographic improvements and reduced the level of pain, although the foot pressure recordings demonstrated no biomechanical effect.