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Chirurgia Del Piede 2001 March;25(1):27-30


language: Italian

Treatment of hallux valgus according to Pisani functional realignment associated with plus osteotomy of the proximal first metatarsal: directions and results

Guido G., Azzone R., Mattugini V., Donati L.


Background. So many methods have been used for the surgical treatment of hallux valgus. In this paper we describe our experience with Pisani's functional rebalance associated with plus osteotomy of the proximal first metatarsal. This technique has been chosen in strictly selected patients.
Methods. We illustrated and described the two techniques with the specific directions to be respected so that their association can realize the best results. From January 1998 to February 2000, twenty patients had been operated joining the Pisani's functional rebalance with plus osteotomy of the proximal first metatarsal. One patient had a bilateral treatment. We had 18 women and 2 males aged between 30 and 55 year old, while the average was 42 years. Follow-up had an average value of 14 months.
Results. All patients were followed clinically and radiographically according to the criteria suggested by the Italian Society of Foot Medicine and Surgery. The subjective evaluation of the patients was measured against the clinical data. Sixteen patients reached complete recovery, and a normal functional activity without pain. In 3 cases there was molded pain with good function. Only one patient appeared absolutely displeased with his own result.
Conclusions. This double and associated surgery can give relief to patients with painful hallux valgus, correcting both the bone alignment defects of the first metatarsal and the position of the sesamoids at the first metatarso-falangeal joint. At the same time give the possibility to remove the bunion completely. If the directions for this kind of surgery are strict the result becomes really appreciable.

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