Médecine et chirurgie du pied


Does Hallux Valgus Surgical Correction Change the Architecture of the Rearfoot? Volume 35, issue 3, Septembre 2019


  • Tableau 1

The valgus deformity of the hallux resonates on the biomechanics of the whole foot. It has been demonstrated that excessive pronation of the rearfoot is associated with this pathology. The purpose of this work was to study the effect of forefoot correction on the rearfoot morphometry. We have collected all records of patients operated for advanced hallux valgus and managed by Scarf osteotomy associated with Weil osteotomies. We compared before and after the correction, 3 parameters on the anterior-posterior foot radiographs (talar uncovering, calcaneal cuboid and intermetatarsal angle) and 4 parameters on the foot lateral radiographs (calcaneal inclination angle, talar declination, talar-first metatarsal, and medial cuneiform height). Our study included 46 patients (47 feet, 37 women and 9 men). The average age of patients was 54.34 years. Comparison of pre- and postoperative radiographs demonstrated that Scarf osteotomy associated with Weil's osteotomy improved the medial longitudinal arch, decreasing the M1M2 intermetatarsal angle and talar-first metatarsal angle. In contrast, the calcaneal inclination, talar declination, talar uncovering and calcaneal cuboid angle were not significantly affected. The Scarf osteotomy associated with Weil osteotomies is currently the Gold Standard in the surgical treatment of advanced hallux valgus. However this technique does not contribute to a significant alignment of the rearfoot to one year of surgery.