Intramedullary locking mini-plate screw system in Lindgren osteotomy: a more effective fixation technique in mild and moderate hallux valgus cases

M. Uluöz, M.Y. Gökmen

Department of Orthopedics and Traumatology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey. mehmet_yigit_gokmen@hotmail.com

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• Orthopedics

OBJECTIVE: In the treatment of mild and moderate hallux valgus (HV) cases, the Lindgren distal osteotomy (LDO) technique has been one of the most frequently preferred methods, and screw fixation has been the most preferred material for surgery. However, considering the implant removal operations due to the reaction to the material,  the risk of unsteadiness, retarded union, and malunion has limited the amount of safe application of lateralization of the distal fragment in distal osteotomy surgery and has yielded the researchers for a better alternative. This study compared the results of the LDO cases using headless cannulated screws and intramedullary plate fixation materials.

PATIENTS AND METHODS: The retrospective study included 31 files of patients operated for HV between January 1, 2018, and December 31, 2022, in Adana City Training and Research Hospital Orthopedics Clinic, Adana, Turkey. In the radiological evaluation, the hallux valgus angle (HVA), the intermetatarsal angle (IMA), the length of the first metatarsal (ML), and the distal metatarsal articular angle (DMAA) recorded preoperatively and postoperatively were analyzed. The functional results of the operations were evaluated by using the Visual Analog Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS), and EuroQol (EQ-5D) scores.

RESULTS: Postop HVA, IMA, MU, and DMMA values were significantly higher in patients in Group 1 than in patients in Group 2 (p<0.001; p=0.004; p=0.004; p=0.049; p<0.001, respectively). The change in Delta (∆) HVA and EQ-5D values was significantly higher in patients in Group 2 compared to patients in Group 1 (p=0.020; p=0.016, respectively).

CONCLUSIONS: The easily available and low-cost locking plates produced for mini-fractures may safely be used in distal osteotomy surgery of mild and moderate HV successfully combined with screws if intramedullary-placed, allowing accurate lateralization and improving overall outcome.

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