J Korean Foot Ankle Soc.  2016 Dec;20(4):158-162. 10.14193/jkfas.2016.20.4.158.

The Effect of Weightbearing after Distal Reverse Oblique Osteotomy for Bunionette Deformity

• Kim GL
• Hyun Y
• Shin JH
• Choi S
• Kim K
• Park J

• KMID: 2362763
• DOI: http://doi.org/10.14193/jkfas.2016.20.4.158

Abstract

PURPOSE
To evaluate the radiological and clinical effects of early eightbearing after distal reverse oblique osteotomy of bunionette.
MATERIALS AND METHODS
Between 2009 and 2015, 52 patients who underwent surgical treatment at our hospital for bunionette deformity with a minimum follow up of one year were included in the study. Postoperatively, foot cast was applied and full weightbearing was permitted in 28 patients. And short leg splint was applied with only partial weightbearing using crutches allowed in 24 patients. Clinical scores were evaluated. Radiologically, the 4th~5th intermetatarsal angle (IMA), and 5th metatarsophalangeal angle (MPA) were analyzed preoperatively and at the final follow up visit.
RESULTS
The visual analogue scale and American Orthopaedic Foot and Ankle Society scores improved in the partial weightbearing group and full weightbearing group, but without significant differences. The average 4th~5th IMA and average 5th MPA correction also did not showed significant differences between the partial weightbearing group and full weightbearing group. Moreover, the full weightbearing group did not encourage non-union rate compared with the partial weightbearing group.
CONCLUSION
Effective bone union may be achieved through early weightbearing, resulting in better clinical outcomes. It is considered that early weightbearing did not have any effect on the changes of IMA and bone union.

Keyword

Bunionette; Weightbearing; Cast; Splint

MeSH Terms

Ankle
Bunion, Tailor's*
Congenital Abnormalities*
Crutches
Follow-Up Studies
Foot
Humans
Leg
Osteotomy*
Splints
Weight-Bearing*

Figure

• 

  Figure 1. (A) The oblique osteotomy is started at the fifth metatarsal neck, and angled 40° to 45° in a proximal direction. (B) The distal fragment is removed and used for bone graft at the osteotomy site. (C) Finally, metatarsal head was translated proximally and medially.

• 

  Figure 2. (A) A lateral radiograph of a foot shows a short leg splint applied postoperatively. (B) A lateral radiograph of another foot shows a foot cast applied postoperatively.

• 

  Figure 3. (A) Preoperative standing anteroposterior radiograph shows a foot with bunionette deformity. (B) Bunionette deformity was corrected postoperatively. (C) At one year postoperatively, complete bony union was confirmed.

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