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Re: Hallux valgus- выбор тактики
A.Liberson 27 Май 2014, 18:17
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Dear Alexsandr,
Providing there is a rigidus, the women is young, I would fuse her with a dorsal plate. A large IMA could be fixed with a proximal osteotomy . In my cases than you bring her to congruity if the range of movement improves you might leave her with a joint ,possibly extension osteotomy at the
level of Akin. You should also deal with pronation in the same time and might improve the toe Valgus. I fix it with a Barouk screw . Be sure that the a flexor and extensor tendi are under and over the ray. I excise the bunion and shorten as needed. If you spare the MPJ the paroxymal osteotomy may be changed to LAPIDUS and the correction made by joint resection. Be sure to plantar flex the first ray. In case the lateral rays appear too long
shorten them with Weil. Be sure the rays 2,3,4 do not go down. At whole you need good screws.
Good luck.
A.L.
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