Helal osteotomy at surgical treatment of metatarsalgia

Abstract

Treatment of metatarsalgia in patients with hallux valgus deformity is one of orthopedic problem. It is known about a significant role in the relationship of the length of the metatarsal feet bones and biomechanical metatarsalgia. A number of surgeries have been proposed, including Helal osteotomy, which consists mainly in the posterior displacement of the metatarsal head and it shows good results. Objective: to study the results of surgical treatment of metatarsalgia caused by biomechanical disorders in patients with hallux valgus deformity with corrective Helal osteotomy. Methods: the study is based on the surgical treatment of 114 (179 feet) patients with hallux valgus deformity. Among them, metatarsalgia was found in 32 (17.9 %) of cases. For its treatment corrective osteotomy of the metatarsal bones was used according to the Helal method with screw fixation. Results: according to the ACFAS scale, the average score improved by 32.5 (from 63.1 points before operations to 95.6 points in followup potsurgery period). In 26 (81.3 %) cases with metatarsalgia the regression of symptoms was determined. Conclusions: in our study the frequency of metatarsalgia caused by biomechanical disorders was 17.9 %. In patients with metatarsalgia in 40.6 % of cases metatarsal parabola had small anatomical shape. Surgical treatment of metatarsalgia caused by biomechanical disorders with Helal osteotomy patients allowed us to get positive results in 81.3 % of cases. Helal osteotomy with screw fixation of metatarsal fragments can be an option for the treatment of metatarsalgia.