ILKER ABDULLAH SARİKAYA, ALİ SEKER, OZAN ALİ ERDAL, MEHMET ALİ TALMAC, MUHARREM INAN
Acta Orthopaedica et Traumatologica Turcica - 2018;52(3):174-178
Objective This study aimed to present a treatment algorithm for the correction of the hallux valgus deformity in Cerebral Palsy (CP) patients and to discuss the outcomes based on our clinical and radiological results. Methods 29 patients (45 feet) were included in the study. The mean age of the patients at the time of the surgery was 14 (range 622) years. The mean follow-up was 33 (range 2259) months. A reconstructive procedure was performed on 19 patients (27 feet); a soft tissue surgery and exostectomy of the bunion in six patients (11 feet); and MTP joint arthrodesis in four patients (7 feet). The hallux valgus angle (HVA) and the anteroposterior intermetatarsal angle (IMA) were used for radiologic evaluation and the DuPont Bunion Rating Score was used for clinical evaluation. Results The follow-up period was 36 (range 2259) months in reconstructive group, 27 (range 2429) months in soft tissue group, and 29 (range 2341) months in MTP arthrodesis group. Significant improvements were detected in hallux valgus angle in three groups postoperatively but in soft tissue group correction loss was observed during follow up. Best results were achieved in arthrodesis group and worse in soft tissue group in terms of clinical evaluation. Conclusion According to our results isolated soft tissue procedures are ineffective in CP patients. Soft tissue procedure combined with metatarsal osteotomy has satisfactory results.