Lateralising step-DMMO (MIS) - a midshaft modification of the lateralising DMMO for a powerful correction of a pes adductus during surgical treatment of a hallux valgus.

Surgical treatment of hallux valgus can be very difficult when it occurs together with pes adductus. The medially displaced metatarsal bones prevent a sufficient shifting of the first metatarsal during hallux valgus correction. This can lead to inherently high reoccurrence rates. Open surgical corrections lead to a profound soft tissue trauma and prolonged swelling, while requiring relief from weight-bearing in the affected foot. In this paper, we aim to introduce a useful midshaft modification of the lateralising Distal Metatarsal Minimal-invasive Osteotomy (lat. DMMO) to perform an effective correction of a metatarsus adductus during hallux valgus surgery. 35 patients with a hallux valgus and simultaneous pes adductus deformity who were treated with MICA and a lateralising step-DMMO were followed-up. The radiological and clinical outcomes after a follow-up period of 24 months confirmed a sustained and effective correction of the pes adductus with a well-aligned hallux. We observed no relevant complications and a high level of patient satisfaction. An immediate pain-adapted, post-operative weight-bearing was possible. LEVEL OF CLINICAL EVIDENCE: 3.