Pe rc uta ne o us pro xima l o b liq ue o ste o to my fixe d (ludlo - - PowerPoint PPT Presentation

Pe rc uta ne o us pro xima l o b liq ue o ste o to my fixe d (ludlo ff) to the surg ic a l tre a tme nt o f se ve re ha llux va lg us: e va lua tio n a nd re sults I g o r Ma rijusc hkin

Sa n Ga b rie l I nstitute Sa n L uc a s Ho spita l-Sa nto s-SP-Bra sil

T HE AUT HOR HAVE NO CONF L I CT S T O DI SCL OSE

I

ntro duc tio n

• T

he pro xima l o b liq ue o ste o to my simila r to the L udlo ff indic a te d in the se ve re ha llux va lg us, ha s the a dva nta g e g re a t c o rre c tive c a pa c ity a nd g o o d sta b ility c o mpa re d to o the r te c hniq ue s de sc rib e d to this pro c e dure

• We pe rfo rm a pe rc uta ne o us ludlo ff o ste o to my ha ving the a dva nta g e o f

lo we r a g g re ssio n o f so ft pa rts wo rldwide tre nd in va rio us fie lds o f me dic ine .

Ob je c tive

• to pre se nt the c linic a l a nd ra dio g ra phic re sults o f surg ic a l

c o rre c tio n o f se ve re ha llux va lg us using pe rc uta ne o us pro xima l

• b liq ue o ste o to my (L

udlo ff) fixe d with sc re w.

Me tho ds

• We e va lua te d pro spe c tive ly 15 fe e t in 14 pa tie nts with se ve re ha llux va lg us
• Ha llux va lg us a ng le (HVA) g re a te r tha n 30 de g re e s
• I

nte rme ta ta rsa l a ng le (I MA) g re a te r tha n 17 de g re e s

• T

he me a n fo llo w-up wa s 18 mo nths (12 to 36)

• 93% fe ma le
• T

he me a n a g e 66,9 ye a rs (29 a 78)

Surg e ry T

e c hniq ue

• 1. L

udlo ff o ste o to my Ste p o ne : Mini-inva sive

• ste o to my

with sha nno n 2.0 Drill ho le Ste p two : de slo c a tio n with k wire Ste p thre e : fixe d with 3.0 sc re w

Surg e ry T

e c hniq ue

• 2. Pe rc uta ne o us e xo ste c to my

Ste p o ne : I nc isio n Be a ve r64 Ste p two : e xo ste c to my With We dg e 3.1

Surg e ry T

e c hniq ue

• 3. Dista l so ft tissue re a le a se

Surg e ry T

e c hniq ue

• 4. Akin Oste o to my:

pe rc uta ne o us a nd inc o mple te with c a lo c la sia we dg e 3.1 drill ho le

Re sults

• T

he me a n pre o pe ra tive Ha llux Va lg us Ang le (HVA) de c re a se fro m 39.7 de g re e s (30 to 51) to 18 de g re e s (8 to 28)

• T

he me a n pre o pe ra tive I nte rme ta ta rsa l Ang le (I MA) de c re a se fro m 18.6 de g re e s (17 to 22) to 13.8 de g re e s (7 to 17)

• T

he me a n AOF AS sc o re 43 to 88,6 po ints One ye a r fo llo w up

Co mplic a tio ns

• 33% o f c a se s
• 1 re c urre nc e o f de fo rmity in le ss tha n 1 ye a r
• 1 tra nsfe re nc e me ta ta rsa lg ia
• 2 withdra wa ls o f synthe sis
• c o mpla int o f do rsa l c a llo sity due to pro b a b le e le va tio n o f 1

me ta ta rsa l

• a pa tie nt unha ppy with the re sult (re c urre nc e c a se )
• No ma jo r c o mplic a tio ns we re no te d

Co nc lusio n

• the surg ic a l te c hniq ue de sc rib e d pro ve d e ffe c tive in the tre a tme nt o f

se ve re va lg us ha lux with impro ve me nt o f the AOF AS sc o re , hig h le ve l o f pa tie nt sa tisfa c tio n a nd g o o d ra dio g ra phic c o rre c tio ns

• We ha ve the a dva nta g e o f lo we r a g g re ssio n o f so ft pa rts wo rldwide tre nd in

va rio us fie lds o f me dic ine

• 1. L

udlo ff K . Die b e se itig ung de s ha llux va lg us durc h die sc hr7g e pla nta -do rsa le

• ste o to mie de s me ta ta rsus I

. Arc h K lin Chir 1918;110:364– 87. 2. De L a vig ne C, Ra smo nt Q, Ho a ng B. Pe rc uta ne o us do ub le me ta ta rsa l o ste o to my fo r c o rre c tio n o f se ve re ha llux va lg us de fo rmity. Ac ta Ortho p Be lg . 2011; 77:516.

• 3. Pinne y SJ, So ng K

R,Cho u L B.Surg ic a l tre a tme nt o f se ve re ha llux va lg us: the sta te

• f

pra c tic e a mo ng a c a d e mic fo o t a nd a nkle surg e o ns. F

• o t Ankle I

nt; 27(12): 1024-9, 2006 De c .