J Korean Foot Ankle Soc.  2004 Dec;8(2):131-137.

The Effect of Sesamoid Position on Results of Treatment for Hallux Valgus

• Yoo CI
• Lee DH
• Kim HT

Abstract

PURPOSE: We evaluated the results of various surgical treatments for hallux valgus with and without attempting to correct sesamoid subluxation.
MATERIALS AND METHODS
Thirty-one cases in 26 patients were involved in this study: Group I (15 cases) - surgery performed only to correct the hallux valgus angle (HVA) and the first-second intermetatarsal angle (IMA) in AP view; Group II (16 cases) - surgery performed to correct HVA and IMA and also to reduce the subluxation of sesamoid. The degree of sesamoid subluxation was measured from a pre- and intraoperative sesamoid tangential views. For both groups, we analysed the status of the sesamoid in pre- and postoperative radiographs and performed clinical evaluation using the Mayo clinic forefoot scoring system.
RESULTS
The average amount of correction during postoperative period and loss of correction at last follow-up in the sesamoid tangential view were as follows: soft tissue procedures (5 cases) - group I: grade 1.0+/-0.4/1.5+/-0.3 and group II: grade 2.0+/-0.9/0.5+/-0.08; chevron osteotomy (12 cases) - group I: grade 1.0+/-0.5/1.2+/-0.3 and group II: grade 2.2+/-0.7/0.9+/-0.2; proximal metatarsal osteotomy (14 cases) - group I: grade 4.0+/-0.4/1+/-0.2 and group II: grade 4.7+/-1.1/0.8+/-0.1. In clinical evaluation, more than 93% of the feet had a good result in both groups. The analysis of these data for each treatment type did not show any statistically significant differences between groups I and II.
CONCLUSION
The radiologic and clinical results did not validate our attempts to reduce the sesamoid during surgery.

Keyword

Hallux valgus; Sesamoid subluxation

MeSH Terms

Follow-Up Studies
Foot
Hallux Valgus*
Hallux*
Humans
Metatarsal Bones
Osteotomy
Postoperative Period