MODIFIED AUSTIN PROCEDURE FOR CORRECTION OF HALLUX-VALGUS

The Austin osteotomy is a widely accepted method for correction of mil d and moderate hallux valgus. In view of publications by Kitaoka et al . in 1991 and by Mann and colleagues, a more radical lateral soft tiss ue procedure was added to the originally described procedure. From Sep tember 1992 to January 1994, 85 patients underwent an Austin osteotomy combined with a lateral soft tissue procedure to correct their hallux valgus deformities. Seventy-nine patients (94 feet) were available fo r followup. The average patient age at the time of the operation was 4 7.1 years, and the average follow-up was 16.2 months. The average preo perative intermetatarsal angle was 13.9 degrees, and the average hallu x valgus angle was 29.7 degrees. After surgery, the feet were correcte d to an average intermetatarsal angle of 5.8 degrees and an average ha llux valgus angle of 11.9 degrees. Sesamoid position was corrected fro m 2.1 before surgery to 0.5 after surgery. The results were also grade d according to the Hallux Metatarsophalangeal Interphalangeal Score, a nd the functional and cosmetic outcomes were graded by the patient. Di ssection of the plantar transverse ligament and release of the lateral capsule repositioned the tibial sesamoid and restored the biomechanic s around the first metatarsophalangeal joint. There was no increased i ncidence of avascular necrosis of the first metatarsal head compared w ith the original technique.