Histological study of the phalangeal articular side following Keller procedure for hallux valgus.

Abstract

Through a histological study, the authors have examined the coating tissue at the base of the proximal phalanx of the hallux. This study concerns five females who have undergone an operation according to Keller technique, and necessitated a reoperation for unsatisfactory results at the first operation. The study proves that resection of the phalanx leads, in time, to the formation of a coating fibrous cartilage. Such layer tends to reproduce a structure that is similar to an articulation, even though missing a hyaline cartilage. This microscopical structure supports well the load that is directed along the perpendicular axis of the phalanx, preserving, in time, a sufficient gliding capacity between the two surfaces, with optimal limitation of the natural wear-out process.