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. 2021 Mar;9(2):211-216.
doi: 10.22038/abjs.2020.47336.2319.

Percutaneous Foot Surgery without Osteosynthesis in Hallux Valgus and Outcomes

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Percutaneous Foot Surgery without Osteosynthesis in Hallux Valgus and Outcomes

Giuseppe Restuccia et al. Arch Bone Jt Surg. 2021 Mar.

Abstract

Background: Several procedures and types of osteotomies have been described for hallux valgus (HV) correction. Percutaneous techniques may lead to an early regain of function reducing morbidity and recovery time. In this study, we aimed to evaluate the clinical and radiographic outcomes of percutaneous hallux valgus (HV) correction.

Methods: One hundred and twenty-four feet treated with the percutaneous technique between May 2011 and December 2015 were included in our study. All patients underwent resection of the medial metatarsal exostosis, complete first metatarsal distal osteotomy, adductor hallucis tendon release and Akin osteotomy of the proximal phalanx. Pre- and postoperative X-rays were clinically assessed.

Results: The mean hallux valgus angle (HVA) and the intermetatarsal angle (IMA) decreased significantly from the preoperative assessment to the final follow-up. The AOFAS score improved from a mean preoperative value of 70.2 to 93.8 at the final follow-up.

Conclusion: Percutaneous complete distal osteotomy in hallux valgus correction is a safe, reliable and effective procedure for the correction of symptomatic mild hallux valgus. Nevertheless, it requires appropriate surgical experience and patient aftercare in order to achieve the best result.

Keywords: Hallux valgus; ercutaneous foot surgery; steosynthesis.

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Figures

Figure 1
Figure 1
Hallux valgus of the left foot treated with PFS. In the preoperative (a) clinical and (b, c) radiological images, HVA was 42°, IMA was 10° and DMAA was 8°.
Figure 2
Figure 2
A wedge burr (left) and a Beaver blade (right).
Figure 3
Figure 3
Hallux valgus of the left foot treated with PFS. Surgical incision is made on the plantar side of the medial border of the first metatarsal.
Figure 4
Figure 4
Osteotomy line
Figure 5
Figure 5
Hallux valgus of the left foot treated with PFS. Intraoperative (a) anteroposterior and (b) oblique fluoroscopic images
Figure 6
Figure 6
Hallux valgus of the left foot treated with PFS. Corrective bandage application.

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