Original article

Croatian rotatory oblique three-dimensional osteotomy (CROTO) – a modified Wilson’s osteotomy for adult hallux valgus intended to prevent dorsal displacement of the distal fragment and to reduce shortening of the first metatarsal bone

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Abstract

Aim: To evaluate biomechanical and clinical outcomes of a newly developed modification of the Wilson's osteotomy for hallux valgus: a three-dimensional subcaptial correction of the metatarsal head position with a simultaneous lateral and plantar shift with derotation intended to reduce displacement of the distal fragment and shortening of the first metatarsal bone.

Methods: Thirty four feet (28 female patients) underwent the new procedure and were evaluated before and 12 to 84 months (medi-an=25.5) after the surgery.

Results: Plantar shift of the distal fragment was achieved in all feet. Shortening of the first metatarsal was moderate: ?6 mm in 32/34 feet, 7 and 10 mm in the remaining two. Median difference in metatarsal index post-vs. pretreatment was-4.0. The hallux valgus angle, intermetatarsal and distal metatarsal articular angles were reduced in all feet. The American Orthopaedic Foot and Ankle Society score improved in all feet (median increase= 51.5).

Conclusion: The method allows for a lateral and plantar shift with derotation of the distal fragment and a mild/moderate shortening of the first metatarsal bone.

Keywords: hallux valgus, surgery, metatarsal

How to Cite:

Kolundžić, R., Mađarević, M., Trkulja, V., Crnković, T., Šmigovec, I. & Matek, D., (2017) “Croatian rotatory oblique three-dimensional osteotomy (CROTO) – a modified Wilson’s osteotomy for adult hallux valgus intended to prevent dorsal displacement of the distal fragment and to reduce shortening of the first metatarsal bone”, Medicinski glasnik 14(2), 250-256. doi: https://doi.org/10.17392/903-17