Pelet D
Clin Orthop Relat Res. 1981 Jun(157):42-6.
Osteotomy is a good method for correcting a metatarsus varus and a hallux valgus if the first metatarsophalangeal joint has little or no arthritis, no luxation and is mobile. Osteotomy of the neck of the first metatarsal is recommended when the articular surface of the first metatarsophalangeal joint has a certain lateral obliquity. In these cases osteotomy of the base of the metatarsal, which exaggerates this obliquity, should be avoided. Osteotomy allows correction in all planes. As osteotomy of the diaphysis of the proximal phalanx is indicated in cases where the hallux is too long, is pronated, or if there is a phalanx valga. Internal fixation of these osteotomies with a lag screw has the advantage of maintaining the correction and allowing early mobilization. With the above-described technique, a physiologic as well as an aesthetic reconstruction may be obtained. The osteotomy must be performed very carefully in order to avoid the complications of recurrence of deformity, joint stiffness and pain.
如果第一跖趾关节几乎没有或没有关节炎、没有脱位且活动度良好，截骨术是矫正内翻足和拇外翻的好方法。当第一跖趾关节的关节面有一定的外侧倾斜时，建议对第一跖骨颈部进行截骨术。在这些情况下，应避免进行会加剧这种倾斜的跖骨基部截骨术。截骨术可在所有平面进行矫正。当拇趾过长、旋前或存在趾骨外翻时，近端趾骨干截骨术是适用的。用拉力螺钉对这些截骨术进行内固定具有维持矫正并允许早期活动的优点。采用上述技术，可以实现生理和美学上的重建。截骨术必须非常小心地进行，以避免出现畸形复发、关节僵硬和疼痛等并发症。
