Abstract: [Abstract] Objective To introduce the surgical strategy of modified V shaped osteotomy on the first distal metatarsal, and to discuss its benefit for the treatment of mild to moderate hallux valgus. Methods Totally 18 hallux valgus patients with refer metatarsalgia (24 feet) were operated by modified V shaped osteotomy on the first distal metatarsal from January in 2008 to January in 2012, all females, with an average age of 42.6 years (range, 30 to 55 years). Pre- and postoperation, HVA and IMA1~2 were measured by X-Ray. Plantar pressure was measured by Plantar pressure measurement system. AOFAS scoring system was employed to evaluate clinical curative effect. Results HVA was corrected from 30.2°±3.3° preoperatively to 11.8°±1.8° at the last visit(P<0.05), IMA1~2 was corrected from 13.8°±1.9° preoperatively to 6.6°±1.0° at the last visit(P<0.05), The plantar pressure return to normal postoperatively, AOFAS score was raised from (58.2±8.6) to (92.8±3.4)(P<0.05) postoperatively. Conclusion The surgical strategy of modified V shaped osteotomy on the first distal metatarsal is proved to be effective in treating mild to moderate hallux valgus with refer metatarsalgia, in terms of strong capability of correction, lower incidence of nonunion, allowance of early weight bearing.

Key words: hallux valgus, Osteotomy, orthopedic procedures, refer metatarsalgia, plantar pressure