Surgical treatment of the forefoot deformity in metatarsus adductus

The article presents the case of successful surgical treatment of a female patient with severe deformities of the toes arising from metatarsus adductus. After clinical and radiological examination the patient was diagnosed with a hallux valgus deviation of the first toe, with 60 degrees of valgus deviation angle, and a valgus-hammered deformity of the II, III, IV toes with a dislocation of the II-IV toes. There was a violation of the stato-dynamic function of the foot, severe pain. Two techniques of joint-preserving surgical treatment were selected. Correction of deformation of the first toe was carried out according to the author’s technology, to correct the deformation of other toes was used the author’s technology too.The result of the treatment was the elimination of hallux valgus of the I finger, deformity of the II, III, IV fingers and the entire forefoot. The patient is completely satisfied with the result of the surgical treatment: the aesthetics of the appearance of the foot with complete restoration of functional parameters, which was confirmed by the ability to walk without pain, engage in regular physical activity and use standard shoes. The described clinical case of surgical treatment of severe deformity of the forefoot in metatarsus adductus demonstrates the possibility and importance of joint-saving surgery to obtain a good cosmetic and functional result. The dynamics of AOFAS scores ranged from 44 before surgery and 90 after surgery. Preoperative AOFAS - 52.67 ± 11.07, AOFAS 1 year after surgery - 88.33 ± 3.26. Mean age of the patients was 41.5 ± 15.6 years. Follow-up time since surgery was 13.16 ± 13.36 months.Performing osteotomies of the metatarsal bones in the proposed modifications makes it possible to correct the hallux valgus and deformities of the other toes in metatarsus adductus. As a result of using these technologies, it is possible to reduce the volume of surgical aggression, eliminate dislocations and subluxations, as well as restore the function of the joints of the foot, completely stop pain syndrome, and thereby improve the anatomical and functional indicators of the entire foot.