Surgical treatment of transverse flat feet, hallux valgus

In 766 patients with transverse flatfoot, hallux valgus (1454 feet) the reconstructive operations by CITO technique were performed. The procedure is aimed at the elimination of all components of the deformity and consists in the removal of bone-cartilagenous vegetations along the medial margin of the head of the first metatarsal bone, resection of the base of the proximal phalanx of the great toe (Keller’s operation), transverse subperiosteal osteotomy near the base of the proximal phalanx of the great toe with preservation and bent fracture of external cortex and insertion of the wedge into osteotomy zone. Strengthening of the transverse ligament was performed by passing the lavsan band around the first and fifth metatarsal bone and between metatarsal bones and soft tissues on the plantar side in figure-of-eight. In 337 operations long term results were evaluated in terms from 1 to 23 years. Good results were achieved on 1094 feet (81,8%), satisfactory results - on 211 feet (15,8%) and unsatisfactory results - on 32 feet (2,4%).