Clinical pedographic radiological findings after valgusizing base osteotomy of metatarsal 1: A prospective study.

Aim: This study investigated the influence of valgusizing base wedge osteot omy of metatarsal 1 (MT 1) subsequently on the entire forefoot. Method: Pre - and post-operatively 22 cases were investigated between 1998 and 2000 bot h clinically and radiologically with pedographic analysis in 20 of these ca ses. Results: According to the Kitaoka Score we could establish preoperativ e 37 and postoperative 72 out of 100 possible points. Following the MT 1-ba se wedge osteotomy with a distal soft-tissue procedure, the central forefoo t region (MT 2/3) showed reduced pressure-induced pain, unchanged callus de velopment, and reduced maximum load pressure. When the Plus-index (MT 1 lon ger than MT 2) could be preserved in the valugusizing MT 1-base wege osteot omy, the metatarsalgia in the central forefoot region not only improved gen erally, but also the maximum loading pressure was clearly reduced. in cases with a post-operative Minus-index (MT 1 shorter than MT 2), as well as in those Plus-index cases undergoing a Keller procedure in the valgusizing bas e wedge osteotomy, the elevated pressure values in the central forefoot reg ion persisted. Conclusion: In valgusizing MT 1-base wege osteotomy with pre servation of the Plus-index (MT 1 longer MT 2), metatarsalgia can be improv ed and the maximum loading pressure in the central forefoot can be reduced.