A retrospective study of 63 hallux valgus corrections using the osteodesis procedure

Abstract

Osteotomy procedures have been the most popular approach to hallux valgus deformity correction. Soft tissue approaches have, in general, been regarded as ineffective for moderate and severe hallux valgus deformities. Osteodesis is a soft tissue technique that has been shown to be effective in the past but is still seldom practiced. In the present report, we describe a retrospective study of 63 hallux valgus feet in 36 patients who had undergone the osteodesis procedure. Their mean age was 46 ± 12 years, and the mean follow-up period was 25.4 ± 9.6 months. The surgical technique consisted of metatarsus primus varus deformity correction by intermetatarsal cerclage sutures and hallux valgus deformity correction by rebalancing the ligaments. The first metatarsophalangeal angle improved from a mean of 32.5° ± 7.6° preoperatively to 18.4° ± 7° postoperatively, the first intermetatarsal angle improved from 14.6° ± 2.6° to 6.8° ± 1.8°, and the American Orthopaedic Foot and Ankle Society score improved from 59 ± 14 to 93 ± 8 points. The rate of patient satisfaction after surgery was 92% (33 of 36 patients, 59 of 63 feet). The complications included a second metatarsal stress fracture in 3 feet (5%), metatarsophalangeal joint medial subluxation in 3 feet (5%), and metatarsophalangeal joint stiffness in 5 feet (8%). This soft tissue, nonosteotomy procedure was a safe technique that effectively corrected hallux valgus and metatarsus primus varus deformities of various severities without osteotomy or fusion.

Keywords: bone callus; intermetatarsal cerclage sutures; metatarsal stress fracture; metatarsus primus varus; soft tissue procedure.