J Korean Orthop Assoc.  2008 Dec;43(6):808-812.

Triple Osteotomy for Hallux Valgus in Patient with Osteopetrosis: A Case Report

• Cha SD
• Kim HS
• Yoo JH
• Park JH
• Kim JH
• Joh JW

Abstract

Osteopetrosis is a very rare hereditary musculoskeletal disorder with an unknown cause. There are few reports on this condition with most focusing on long bone fractures. Most patients with osteopetrosis require non-surgical treatment and surgery is technically difficult. Hallux valgus deformities in patients with osteopetrosis are always severe and there are no reports on its treatment. We treated a hallux valgus deformity using triple osteotomy method and experienced nonunion, subluxation of the first metatarsophalangeal joint and screw breakage. This is the first report of the surgical treatment of such a case in Korea. We report this case with a review of the relevant literature.

Keyword

Osteopetrosis; Hallux valgus; Triple osteotomy

MeSH Terms

Congenital Abnormalities
Fractures, Bone
Hallux
Hallux Valgus
Humans
Korea
Metatarsophalangeal Joint
Osteopetrosis
Osteotomy

Figure

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  Fig. 1 (A) This preoperative standing anteroposterior radiograph shows highly increased hallux valgus angle, 1st-2nd intermetatarsal angle and distal metatarsal articular angle. (B) In lateral radiograph, bone within a bone in distal tibia and calcaneus is manifested.

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  Fig. 2 These radiographs show sclerotic change on skull base, Erlenmyer flask deformity of distal femur and sandwich vertebrae.

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  Fig. 3 This postoperative anteroposterior radiograph shows the correction of hallux valgus angle, intermetatarsal angle and distal metatarsal articular angle.

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  Fig. 4 At 9 weeks after operation, standing anteroposterior radiograph shows loss of correction and nonunion at all osteotomy sites.

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  Fig. 5 (A) At postoperative anteroposterior radiograph, distal metatarsal articular angle, hallux valgus angle and intermetatarsal angle were corrected well by using plate and screws. (B) At 30 weeks after reoperation, this anteroposterior radiograph shows complete bony union at osteotomy site, maintenance of corrected angles and breakage of a proximal screw.

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  Fig. 6 At 40 weeks after reoperation, correction angle is maintained well but these radiographs show dorsal subluxation of 1st metatarsophalangeal joint caused by nonunion of proximal phalanx.

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