J Korean Foot Ankle Soc.  2019 Dec;23(4):166-172. 10.14193/jkfas.2019.23.4.166.

Surgical Outcomes of the Reinforcing Technique of a Weakened Medial Capsule in Severe Hallux Valgus Using Internal Brace

Affiliations
  • 1Department of Orthopedic Surgery, Chungnam National University Hospital, Daejeon, Korea. faschan@daum.net
  • 2Da Jeong S.M. Orthopedic Hospital, Sejong, Korea.

Abstract

PURPOSE
This study evaluated the clinical and radiological results after reinforcement of the weakened medial joint capsule using Internal Brace (Arthrex) for treating severe hallux valgus.
MATERIALS AND METHODS
This study reviewed 56 cases of 50 patients that were followed-up postoperatively for at least 12 months, from September 2017 until August 2018. An extended distal chevron osteotomy combined with a distal soft-tissue release was performed by a single surgeon to treat severe hallux valgus. Internal Brace was applied in 12 cases (group A) who had weakened medial joint capsules, and capsulorrhaphy was performed in 44 cases (group B), and these two groups were compared postoperatively for the clinical and radiological results. The postoperative complications were also investigated.
RESULTS
No significant differences at 1-year follow-up on the Manchester-Oxford Foot Questionnaire and the patients' satisfaction scores were found between the two groups (p=0.905 and p=0.668, respectively). For the radiology, the changes of the values between before surgery and at 1-year follow-up according to the group showed no significant differences in the hallux valgus angle, intermetatarsal angle, and the hallux interphalangeal angle (p=0.986, p=0.516, p=0.754, respectively). Recurrence of hallux valgus was reported in two cases in group A, and in three cases in group B. Transfer metatarsalgia occurred in 4 cases in group B.
CONCLUSION
Based on these results, we recommend the capsule reinforcing technique using Internal Brace as a successful operative option for treating a weakened medial capsule in patients with severe hallux valgus.

Keyword

Severe hallux valgus; Extended distal chevron osteotomy; Capsulorrhaphy; Suture tape augmentation

MeSH Terms

Braces*
Follow-Up Studies
Foot
Hallux Valgus*
Hallux*
Humans
Joint Capsule
Metatarsalgia
Osteotomy
Postoperative Complications
Recurrence
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