Incomplete Reduction that Influence Reduction of Sesamoid as a Cause for Recurrence of Hallux Valgus

Yune, Young Phil; Lee, Chul Hyung; Jeong, Hyun Yoon; Kim, Young Woo; Jung, Jae Yong

Abstract

PURPOSE
The incomplete reduction of the sesamoid has lately been issued as cause for recurrence. In this study, we analysed factors that may influence reduction of sesamoid.
MATERIALS AND METHODS
The study consists of 50 cases operated by single surgeon. Eighteen cases were done by proximal chevron osteotomy, and 32 cases were done by scarf osteotomy. Hallux valgus (HV) angle and intermetatarsal (IM) angle were measured before and three months after the surgery. Sesamoid position (SP) was classified according to Hardy and Clapham grade system.
RESULTS
After the proximal chevron osteotomy, the correction of the mean HV angle was 19.5degrees, and IM angle was 6.2degrees. SP was changed from 5.6 to 3.4 grade. After the Scarf osteotomy, the correction of the mean HV angle was 25 degree, and IM angle was 9degrees. SP was changed from 5.5 to 2.8 grade. There was difference of sesamoid's correction between two different method of surgery (p=0.127). However, better correction of sesamoid was witnessed with bigger correction angle regardless of method of surgery (p=0.002, 0.001).
CONCLUSION
We believe surgical method do not effect sesamoid's correction but more correction angle can result in better correction of sesamoid position.