{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T22:21:42Z","timestamp":1767651702051},"reference-count":32,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"4","license":[{"start":{"date-parts":[[2014,4,1]],"date-time":"2014-04-01T00:00:00Z","timestamp":1396310400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":["online.boneandjoint.org.uk"],"crossmark-restriction":true},"short-container-title":["The Bone &amp; Joint Journal"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:p>Metatarsus primus varus deformity correction is one of the main objectives in hallux valgus surgery. A \u2018syndesmosis\u2019 procedure may be used to correct hallux valgus. An osteotomy is not involved. The aim is to realign the first metatarsal using soft tissues and a cerclage wire around the necks of the first and second metatarsals.<\/jats:p><jats:p>We have retrospectively assessed 27 patients (54 feet) using the American Orthopaedic Foot and Ankle Society (AOFAS) score, radiographs and measurements of the plantar pressures after bilateral syndesmosis procedures. There were 26 women. The mean age of the patients was 46 years (18 to 70) and the mean follow-up was 26.4 months (24 to 33.4). Matched-pair comparisons of the AOFAS scores, the radiological parameters and the plantar pressure measurements were conducted pre- and post-operatively, with the mean of the left and right feet. The mean AOFAS score improved from 62.8 to 94.4 points (p &lt; 0.001). Significant differences were found on all radiological parameters (p &lt; 0.001). The mean hallux valgus and first intermetatarsal angles were reduced from 33.2\u00b0 (24.3\u00b0 to 49.8\u00b0) to 19.1\u00b0 (10.1\u00b0 to 45.3\u00b0) (p &lt; 0.001) and from 15.0\u00b0 (10.2\u00b0 to 18.6\u00b0) to 7.2\u00b0 (4.2\u00b0 to 11.4\u00b0) (p &lt; 0.001) respectively. The mean medial sesamoid position changed from 6.3(4.5 to 7) to 3.6 (2 to 7) (p\u00a0&lt; 0.001) according to the Hardy\u2019s scale (0 to 7). The mean maximum force and the force\u2013time integral under the hallux region were significantly increased by 71.1% (p = 0.001), (20.57 (0.08 to 58.3) to 35.20 (6.63 to 67.48)) and 73.4% (p = 0.014), (4.44 (0.00 to 22.74) to 7.70 (1.28 to 19.23)) respectively. The occurrence of the maximum force under the hallux region was delayed by 11% (p = 0.02), (87.3% stance (36.3% to 100%) to 96.8% stance (93.0% to 100%)). The force data reflected the restoration of the function of the hallux. Three patients suffered a stress fracture of the neck of the second metatarsal. The short-term results of this surgical procedure for the treatment of hallux valgus are satisfactory.<\/jats:p><jats:p>Cite this article: Bone Joint J 2014;96-B:502\u20137.<\/jats:p>","DOI":"10.1302\/0301-620x.96b4.32193","type":"journal-article","created":{"date-parts":[[2014,4,1]],"date-time":"2014-04-01T10:08:50Z","timestamp":1396346930000},"page":"502-507","update-policy":"http:\/\/dx.doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["The use of a syndesmosis procedure for the treatment of hallux valgus"],"prefix":"10.1302","volume":"96-B","author":[{"given":"D. W. C.","family":"Wong","sequence":"first","affiliation":[{"name":"Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Yuk Choi Road, Hung Hom, Kowloon, Hong Kong."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. Y.","family":"Wu","sequence":"additional","affiliation":[{"name":"Matilda International Hospital, 41 Mount Kellett Road, The Peak, Hong Kong."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. S.","family":"Man","sequence":"additional","affiliation":[{"name":"Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Yuk Choi Road, Hung Hom, Kowloon, Hong Kong."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. K. L.","family":"Leung","sequence":"additional","affiliation":[{"name":"Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Yuk Choi Road, Hung Hom, Kowloon, Hong Kong."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"42","reference":[{"key":"r1","first-page":"98","volume":"7","author":"Truslow W","year":"1925","journal-title":"J Bone Joint Surg [Am]"},{"key":"r2","doi-asserted-by":"publisher","DOI":"10.1177\/107110070002100804"},{"key":"r3","first-page":"58","volume":"79","author":"Stainsby GD","year":"1997","journal-title":"Ann R Coll Surg Engl"},{"key":"r4","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.01630"},{"key":"r5","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.87B8.16467"},{"key":"r6","doi-asserted-by":"publisher","DOI":"10.1016\/S1268-7731(05)80050-5"},{"key":"r7","doi-asserted-by":"publisher","DOI":"10.1177\/107110070602701118"},{"key":"r8","doi-asserted-by":"publisher","DOI":"10.1177\/107110070602701205"},{"key":"r9","doi-asserted-by":"publisher","DOI":"10.1177\/107110078300300402"},{"key":"r10","unstructured":"Coughlin MJ, Mann RAHallux valgus. 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