Ludloff’s diaphyseal osteotomy in the treatment of hallux valgus

Background Proximal first metatarsal osteotomy combined with distal soft tissue procedure is recommended for the surgical treatment of moderate to severe hallux valgus (HV) deformity with increased intermetatarsal (IM) angle. Materials and methods This is a retrospective study evaluating the results of the Ludloff’s osteotomy, stabilized with two lag screws, for the management of HV cases with HV angle greater than 40° and IM angle greater than 13°. The procedures were undertaken from January 2011 and August 2015 and were done by the authors. The study included 16 female patients. All patients were assessed using the American Orthopedic Foot and Ankle Society Score preoperatively and postoperatively. Results There was a mean correction of HV angle of 30.6° and of IM angle of 7.9°. The average American Orthopedic Foot and Ankle Society Score improved from 48 preoperatively to 92 postoperatively. The average first metatarsal shortening noted was 1.4 mm. One case experienced transfer metatarsalgia. One case had nonunion, which was managed with revision fixation and bone graft. Conclusion Ludloff’s osteotomy is a valuable operative management technique for moderate and severe HV, with low rate of complications.