Abstract
Objective. Hallux pathology surgery is one of the operations we perform at our workplace. The aim of the study is to present an analysis of our operated patients and to show the characteristics of our surgical treatments.

Material and methodology. We operate on patients in the private Clinica Orthopaedica hospital, where we use the "Belegtspital" type of work organization. This means that we treat our patients in an outpatient clinic. We order the operating room in a private hospital. On the day of the operation, the patient comes to the hospital with a pre-operative examination, the hospital then provides hospitalization, offers an operating room and an anesthetist, post-operative monitoring. We perform this type of surgery as part of a one-day surgery. This means that the patient leaves for home care on the day of the operation. If we perform the operation late in the afternoon or in the evening, the patient remains in the hospital until the following morning, when he is discharged to home care. We provide further post-operative medical care in our orthopedic clinic. When applying the "Belegtspital" type of work organization, the indication and surgical autonomy of individual orthopedists and individual preference for surgical reconstructive operations are accepted.
Results. In course of past 10 years (until 2022), we performed 120 orthopedic reconstructions of hallux pathology alone or in combination with other forefoot pathology in all age groups. The youngest patient was 15 years old, the oldest was 78 years old, the majority of operated patients were aged 51-70 years, 83 (69%). 88 (73%) women and 32 (27%) men were operated on. We operated on the following conditions: simple hallux pathology 27x (23%), complex hallux pathology 52x (43%), hallux + pathologia multisegmentalis 41x (34%). Corrective osteotomy, osteosynthesis with Kirschner wire 55x (46%), corrective osteotomy screw fixation 43x (36%), resection osteotomy without osteosynthesis 20x (17%), plate-fixed arthrodesis 2x (1%). Type of anesthesia: spinal 65x (54%), general anesthesia 40x (33%), local anesthesia 15x (1%).
The duration of using the postoperative sandal is 6 weeks. Extraction of stitches 14 days after the operation. Extraction of Kirschner wires 6 weeks after surgery.
Evaluation of satisfaction after 12 months from the operation: satisfaction without difficulties - 68 patients (57%), satisfaction with small deformity without difficulties - 33 patients (27%), small deformity with pain after overload – 14 patients (12%), progression of pathology with mild static pain - 5 patients (4%).
Conclusion. We present our possibilities, the nature of the work and the type of orthopedic reconstruction of the fixation of the corrective position of the front leg. Hallux pathology operations represent 5-7% of our total operations annually. Operations are organized in the form of a "Belegtspital", where, in addition to organizational specificity, there is indication and surgical autonomy of individual orthopedists with a preference for their own surgical reconstruction trends. Dominant anesthesia is general or spinal. For operations, we prefer corrective osteotomies. For osteoporotic bone, we prefer fixation with a Kirschner wire. With good quality, internal fixation with a titanium or absorbable screw. We also point out the risks of internal fixation with a magnesium screw - peri-implant X-ray osteopenia. We document operations for monosegmental hallux pathology or combined pathology in pictorial form (Fig. 21, lit. 5). Text in PDF www.lekarsky.herba.sk.
KEYWORDS: hallux surgery, hallux valgus, Austin osteotomy, metatarsal osteotomy osteosynthesis.

Lek Obz 2024, 73 (4): 148-154

Jozef VOJTAŠŠÁK, Jr.1, Jozef VOJTAŠŠÁK 1,2

1 Orthos Paidion, špecializovaná ortopedická ambulancia, Clinica orthopaedica, Bratislava, vedúci prof. MUDr. J. Vojtaššák, CSc.

2 Slovenská zdravotnícka univerzita, Fakulta ošetrovateľstva Bratislava, dekanka prof. PhDr. Z. Slezáková, PhD., MPH