Results of Ludloff Osteotomy in Hallux Valgus

Purpose: The purpose of this study was to evaluate the outcome of Ludloff osteotomy for treatment of hallux valgus with regard to patient satisfaction and clinical and radiological results. Materials and Methods: 43 feet of 28 patients underwent Ludloff osteotomy between January 2003 and August 2003. 21 patients (32 feet) who were available for follow up for more than one year were enrolled in this study. Average follow up period was 16 months. All patients were female and the average age was 51 years ranging 28 years to 72 years. Patient satisfaction was assessed and VAS (Visual Analogue Scale) was used for subjective outcome, AOFAS (American Orthopaedic Foot and Ankle Society) score and presence of metatarsalgia were used for clinical outcome, and hallux valgus angle and intermetatarsal angle were used for radiological outcome assessment. Results: Patient satisfaction regarding cosmesis was excellent in 6 cases, good in 21 cases, fair in 4 cases and poor in 1 case. VAS was improved from preoperative 6 points to postoperative 2 points and AOFAS score was improved from preoperative 53 points to postoperative 82 points. Metatarsalgia was observed in 18 cases preoperatively and 9 cases postoperatively. HVA and IMA were 35.8 and 15.2 degrees preoperatively, 12.5 and 6.6 degrees at 3 months follow up, and 13.2 and 7.1 degrees at last follow up respectively. At the last follow up, loss of angle of correction for HVA was 0.7 degrees and for IMA was 0.5 degrees. Conclusion: Ludloff osteotomy is an appropriate surgery of moderate to severe hallux valgus.

[1]  L. Schon,et al.  Clinical Results with the Ludloff Osteotomy for Correction of Adult Hallux Valgus , 2004, Foot & ankle international.

[2]  M. Myerson,et al.  Strength of Fixation of Ludloff Metatarsal Osteotomy Utilizing Three Different Types of Kirschner Wires: A Biomechanical Study , 2003, Foot & ankle international.

[3]  M. Myerson,et al.  The Ludloff Metatarsal Osteotomy: Guidelines for Optimal Correction Based on a Geometric Analysis Conducted on a Sawbone Model , 2003, Foot & ankle international.

[4]  M. Nyska,et al.  Proximal Metatarsal Osteotomies: A Comparative Geometric Analysis Conducted on Sawbone Models , 2002, Foot & ankle international.

[5]  L. Schon,et al.  Mechanical Comparison of Cyclic Loading in Five Different First Metatarsal Shaft Osteotomies , 2002, Foot & ankle international.

[6]  R. Claridge,et al.  Crescentic Proximal Metatarsal Osteotomy for Moderate to Severe Hallux Valgus: A Mean 12.2 Year Follow-Up Study , 2001, Foot & ankle international.

[7]  L. Schon,et al.  Six First Metatarsal Shaft Osteotomies: Mechanical and Immobilization Comparisons , 2000, Clinical orthopaedics and related research.

[8]  Acevedo Ji.  Fixation of metatarsal osteotomies in the treatment of hallux valgus. , 2000 .

[9]  M. Salzer,et al.  Basal Closing Wedge Osteotomy for Correction of Hallux Valgus and Metatarsus Primus Varus: 10- to 22-Year Follow-up , 1999, Foot & ankle international.

[10]  Sammarco Gj,et al.  Bunion Correction Using Proximal Chevron Osteotomy: A Single-Incision Technique: , 1998 .

[11]  K. Lee,et al.  Proximal Metatarsal Chevron Osteotomy Combined with Modified McBride Procedures for Hallux Valgus Patients. , 1998 .

[12]  F. Thompson,et al.  Proximal Metatarsal Osteotomy in Hallux Valgus Correction: A Comparison of Crescentic and Chevron Procedures , 1997, Foot & ankle international.

[13]  D. Thordarson,et al.  Hallux Valgus Correction with Proximal Metatarsal Osteotomy: Two-year Follow-up , 1992, Foot & ankle.

[14]  R. Mann,et al.  Repair of hallux valgus with a distal soft-tissue procedure and proximal metatarsal osteotomy. A long-term follow-up. , 1992, The Journal of bone and joint surgery. American volume.

[15]  F. Kummer,et al.  The Stability of Fixation of First Metatarsal Osteotomies , 1991, Foot & ankle.