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Plantar loading after chevron osteotomy combined with postoperative physical therapy.

Publication ,  Journal Article
Schuh, R; Adams, S; Hofstaetter, SG; Krismer, M; Trnka, H-J
Published in: Foot Ankle Int
November 2010

BACKGROUND: Recent pedobarographic studies have demonstrated decreased loading of the great toe region and the first metatarsal head at a short- and intermediate-term followup. The purpose of the present study was to determine if a postoperative rehabilitation program helped to improve weightbearing of the first ray after chevron osteotomy for correction of hallux valgus deformity. MATERIALS AND METHODS: Twenty-nine patients with a mean age of 58 years with mild to moderate hallux valgus deformity who underwent a chevron osteotomy were included. Postoperatively, the patients received a multimodal rehabilitation program including mobilization, manual therapy, strengthening exercises and gait training. Preoperative and one year postoperative plantar pressure distribution parameters including maximum force, contact area and force-time integral were evaluated. Additionally the AOFAS score, ROM of the first MTP joint and plain radiographs were assessed. The results were compared using Student's t-test and level of significance was set at p < 0.05. RESULTS: In the great toe, the mean maximum force increased from 72.2 N preoperatively to 106.8 N 1 year after surgery. The mean contact area increased from 7.6 cm(2) preoperatively to 8.9 cm(2) 1 year after surgery and the mean force-time integral increased from 20.8 N(*)sec to 30.5 N(*)sec. All changes were statistically significant (p < 0.05). For the first metatarsal head region, the mean maximum force increased from 122.5 N preoperatively to 144.7 N one year after surgery and the mean force-time integral increased from 42.3 N(*)sec preoperatively to 52.6 N(*)sec 1 year postoperatively (p = 0.068 and p = 0.055, respectively). The mean AOFAS score increased from 61 points preoperatively to 94 points at final followup (p < 0.001). The average hallux valgus angle decreased from 31 degrees to 9 degrees and the average first intermetatarsal angle decreased from 14 degrees to 6 degrees (p < 0.001 for both). CONCLUSION: Our results suggest that postoperative physical therapy and gait training with a Chevron osteotomy may help to improve weightbearing of the great toe and first ray. Therefore, we believe there is a restoration of more physiological gait patterns in patients who receive this postoperative regimen.

Duke Scholars

Published In

Foot Ankle Int

DOI

ISSN

1071-1007

Publication Date

November 2010

Volume

31

Issue

11

Start / End Page

980 / 986

Location

United States

Related Subject Headings

  • Weight-Bearing
  • Prospective Studies
  • Pressure
  • Postoperative Care
  • Physical Therapy Modalities
  • Osteotomy
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
 

Citation

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Schuh, R., Adams, S., Hofstaetter, S. G., Krismer, M., & Trnka, H.-J. (2010). Plantar loading after chevron osteotomy combined with postoperative physical therapy. Foot Ankle Int, 31(11), 980–986. https://doi.org/10.3113/FAI.2010.0980
Schuh, Reinhard, Samuel Adams, Stefan Gerhard Hofstaetter, Martin Krismer, and Hans-Joerg Trnka. “Plantar loading after chevron osteotomy combined with postoperative physical therapy.Foot Ankle Int 31, no. 11 (November 2010): 980–86. https://doi.org/10.3113/FAI.2010.0980.
Schuh R, Adams S, Hofstaetter SG, Krismer M, Trnka H-J. Plantar loading after chevron osteotomy combined with postoperative physical therapy. Foot Ankle Int. 2010 Nov;31(11):980–6.
Schuh, Reinhard, et al. “Plantar loading after chevron osteotomy combined with postoperative physical therapy.Foot Ankle Int, vol. 31, no. 11, Nov. 2010, pp. 980–86. Pubmed, doi:10.3113/FAI.2010.0980.
Schuh R, Adams S, Hofstaetter SG, Krismer M, Trnka H-J. Plantar loading after chevron osteotomy combined with postoperative physical therapy. Foot Ankle Int. 2010 Nov;31(11):980–986.
Journal cover image

Published In

Foot Ankle Int

DOI

ISSN

1071-1007

Publication Date

November 2010

Volume

31

Issue

11

Start / End Page

980 / 986

Location

United States

Related Subject Headings

  • Weight-Bearing
  • Prospective Studies
  • Pressure
  • Postoperative Care
  • Physical Therapy Modalities
  • Osteotomy
  • Orthopedics
  • Middle Aged
  • Male
  • Humans