Fiches A4 R-V ostéo phalang 2P HALLUX VALGUS Document produced by the TALUS group of GECO (www.geco-medical.org) - 2004. It may be necessary to complete the metatarsal correction by means of a phalangeal osteotomy (known as an Akin osteotomy). Phalangeal osteotomy is considered appropriate for 3 types of corrections : > shortening in cases of gigantism of the hallux necessitating a bicortical reduction osteotomy or a shortening osteotomy, > correction of an interphalangeal valgus with a varisation osteotomy, > correction of pronation with a derotation osteotomy. This osteotomy permits correction in 3 planes of the space and brings about correction by shortening, varisation and derotation. PHALANGEAL OSTEOTOMY PHALANGEAL OSTEOTOMY OSTEOTOMIES The osteotomy is performed with an oscillating saw. The principle is to perform the distal osteotomy parallel to the root of the nail (1st line) and the proximal osteotomy parallel to the base of the 1st phalanx (2nd line). A triangle or parallelepiped-shaped resection is then performed correcting the interphalangeal valgus. Before correction After correction

Fiches A4 R-V ostéo phalang 2P PHALANGEAL OSTEOTOMY SNAP-OFF SELF-COMPRESSING SCREW Fixation of the osteotomy is then performed simply by the oblique insertion of a self-compressing screw (generally using the larger sizes from L26 to L30), which makes it possible to obtain: > excellent primary stability due to the quality of bony purchase distally; a consequence of: - sufficiently large screw diameter, - appropriate distal thread size in cancellous bone (equivalent to the cancellous thread of the AO small fragment screw). > excellent inter-fragmentary compression due to the differential thread....