Is it feasible to rely on intraoperative X ray in correcting hallux valgus?
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ORTHOPAEDIC SURGERY
Is it feasible to rely on intraoperative X ray in correcting hallux valgus? N. Gutteck • D. Wohlrab • F. Radetzki A. Zeh • M. Ro¨llinghoff • K. S. Delank S. Lebek
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Received: 18 November 2012 / Published online: 17 March 2013 Ó Springer-Verlag Berlin Heidelberg 2013
Abstract Background The aim of the study was to prove whether the intraoperatively taken fluoroscopy pictures compared to the X rays taken 8 weeks and 3 months postoperatively picture the achieved correction reliably. Method In a prospective study, the pre- and postoperative standing foot X rays as well as the intraoperatively taken fluoroscopy pictures of 31 patients were analysed. The intermetatarsal angle (IMA) and the hallux valgus angle (HVA) were measured. In all cases, a tarso-metatarsal joint I arthrodesis combined with a distal soft tissue release was performed. The mean age was 54 (17–73) years. Results There was no significant difference between the measured angles in intraoperative fluoroscopy and standing X rays postoperatively taken. Conclusions Despite the consideration that fluoroscopic pictures lack the loading criteria, we found reliable results in IMA and HVA.
tarso-metatarsal joint I (TMT I) is an established method of treating a hallux valgus especially with a joint pathology. Thereby, the TMT I joint instability plays a key role in the development of the hallux valgus deformity [1–4]. Thus far, it is not clear whether the intraoperatively taken fluoroscopic pictures without loading are reliable enough to picture the achieved correction. In a prospective study, the pre- and postoperative standing X rays as well as the intraoperatively taken image intensifier pictures were analysed by measuring the intermetatarsal angle (IMA) and the hallux valgus angle (HVA) to answer the question of how reliable the results are. The aim of the study was to prove whether the intraoperatively taken fluoroscopy pictures compared to the X rays taken 8 weeks and 3 months postoperatively picture the achieved correction reliably. So far, there are no similar studies after TMT I arthrodesis in the literature.
Keywords Hallux valgus Lapidus procedure Arthrodesis Tarsometatarsal joint
Materials and methods
Introduction The intraoperative use of fluoroscopy is well established. In many foot operations, it is essential. The arthrodesis of the
N. Gutteck (&) D. Wohlrab F. Radetzki A. Zeh M. Ro¨llinghoff K. S. Delank S. Lebek Department of Orthopaedic Surgery, Martin Luther University Halle Wittenberg, Magdeburger Straße 22, 06112 Halle (Saale), Germany e-mail: [email protected]
In a prospective study, X rays and image intensifier pictures of 31 patients (26 female, 5 male) operated on for correction of a hallux valgus deformity were analysed. In all cases, a TMT I arthrodesis combined with a distal soft tissue release was performed by one orthopaedic surgeon. In all but six cases, it was combined with an Akin procedure to accomplish an orthograde alignment of the first ray. The mean age was 54 (17–73) years. The
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