PMC6742876_01
The patient has both hallux valgus with 1stand 4th brachymetatarsia and both 3rd clawing toe(a). On the both sole, there were 3 x 3 cm sized painful corn(b).
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F1
A 56-year-old female patient was hospitalized for bilateral hallux valgus and painful corns on the sole of her both feet with brachymetatarsia (Fig. 1).
Pre-operative radiograph of both feet shows both hallux valgus and 1st and 4th brachymetatarsia.
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F2
Simple radiography demonstrated moderate degrees of hallux valgus, mild brachymetatarsia of first-ray and severe fourth brachymetatarsia in bilateral feet (Fig. 2).
Scarf osteotomy for bilateral hallux valgus and bilateral 2nd, 3rd, 5th metatarsal Weil osteotomy, and 4th metatarsal callotasis for the fourth brachymetatarsia were performed.
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F3
To maintain the alignment of the interphalangeal joint and prevent the flexion deformity of the metatarsal head, K-wire was inserted from the distal phalanx to the distal part of the metatarsal (Fig. 3).
Post - operative 8 weeks anteroposterior radiograph shows shortened 2nd, 3rd, and 5th rays and lengthened 4th ray applied external fixator and K-wires.
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F4
After the 8th week after surgery, the length remained the same (Fig. 4), then the external fixator was removed after confirming of callus formation at the post-operative 11th week (Fig. 5).
10 years after surgery, there is no restriction during active weight-bearing dorsi flexion (a) and no painful callosity on the sole of both feet(b).
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F6
The active joint of the foot movement during the 10 years since the surgery has returned to its normal range in all joins (Fig. 6).
In the post-operative 10-year radiograph, there is no recurrence of hallux valgus, and the normal metatarsal parabola has been maintained.
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F7
Before the surgery, the America Orthopedic Foot and Ankle Surgery (AOFAS) scores finally improved from 52 to 90, and the AOFAS, AOFAS's first toe score improved from 41 to 88.10 years later, there were no aftereffect from the simple radiography such as metatarsophalangeal osteoarthritis, and so on (Fig. 7).