Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Jan-Apr;18(1):51-55.
doi: 10.5005/jp-journals-10080-1579.

Growth Modulation for the Treatment of Juvenile Hallux Valgus: A Systematic Review of Literature

Muadh AlZeedi  1 , J Patrick Park  1 , Yousef Marwan  2 , Khaled Mousa Abu-Dalu  1 , Reggie Hamdy  1 , Chantal Janelle  1
Affiliations
Review

Growth Modulation for the Treatment of Juvenile Hallux Valgus: A Systematic Review of Literature

Muadh AlZeedi et al. Strategies Trauma Limb Reconstr. 2023 Jan-Apr.

Abstract

Background: Juvenile hallux valgus (JHV) is a forefoot deformity that causes pain and functional limitation. Treatment poses a challenge in terms of the optimal technique and timing of intervention. A systematic review of the literature on the use of growth modulation in treating JHV was conducted.

Materials and methods: The literature review was performed using PubMed and EMBASE searches for articles investigating growth modulation in the treatment of JHV published before December 1st, 2021. Seven articles were included in the final review that matched the inclusion and exclusion criteria. The primary outcomes included the degree of correction of hallux valgus angle and intermetatarsal angle. A qualitative assessment of the articles was done due to the heterogeneity of the growth modulation methods used in these articles.

Results: A total of 135 feet from 78 patients were included from the reviewed articles. Growth modulation methods included temporary screw lateral hemiepiphysiodesis of the first metatarsal, lateral drilling hemiepiphysiodesis of the first metatarsal, and a trephine plug removal of the lateral epiphysis followed by cancellous bone graft insertion. The degree of correction of the hallux valgus and intermetatarsal angles were found to be statistically significant in all studies, regardless of the technique.

Conclusion: Growth modulation for JHV by lateral hemiepiphysiodesis using minimally invasive techniques produced favourable radiologic outcomes with some evidence of clinical improvement. Larger, prospective and comparative studies with objective clinical outcome measures may further consolidate this surgical approach as a mean to treating this deformity.

How to cite this article: AlZeedi M, Park JP, Marwan Y, et al. Growth Modulation for the Treatment of Juvenile Hallux Valgus: A Systematic Review of Literature. Strategies Trauma Limb Reconstr 2023;18(1):51-55.

Keywords: Epiphysiodesis; Growth modulation; Hemiepiphysiodesis; Juvenile hallux valgus; Paediatric hallux valgus.

PubMed Disclaimer

Conflict of interest statement

Source of support: Nil Conflict of interest: None

Figures

Flowchart 1
Flowchart 1
Flowchart of article selection
See this image and copyright information in PMC

References

    1. Chell J, Dhar S. Pediatric hallux valgus. Foot Ankle Clin. 2014;19(2):235–243. doi: 10.1016/j.fcl.2014.02.007. - DOI - PubMed
    1. Coughlin MJ. Juvenile hallux valgus: Etiology and treatment. Foot Ankle Int. 1995;16(11):682–697. doi: 10.1177/107110079501601104. - DOI - PubMed
    1. Groiso JA. Juvenile hallux valgus. A conservative approach to treatment. J Bone Joint Surg Am. 1992;74(9):1367–1374. 1429792 - PubMed
    1. Ball J, Sullivan A. Treatment of the juvenile bunion By Mitchell osteotomy. Orthopedics. 1985;8(10):1249–1252. doi: 10.3928/0147-7447-19851001-09. - DOI - PubMed
    1. Canale PB, Aronsson DD, Lamont RL, et al. The Mitchell procedure for the treatment of adolescent hallux valgus. A long-term study. J Bone Joint Surg. 1993;75(11):1610–1618. doi: 10.2106/00004623-199311000-00005. - DOI - PubMed

LinkOut - more resources