Treatment of Juvenile Hallux Valgus with a Simple, Effective, Rapid, and Inexpensive (SERI) technique: A systematic review and meta-analysis

Abstract

Juvenile hallux valgus presents pediatric challenges ranging from cosmetic to functional issues, with multiple surgical management strategies reported. The simple, effective, rapid, and inexpensive (SERI) technique has gained attention for its potential to offer effective correction with minimal complications. Its effectiveness in younger patients is still uncertain. This systematic review and meta-analysis evaluates the outcomes of SERI in treating Juvenile hallux valgus. Medline, Embase, Cochrane CENTRAL, CINAHL Complete, and SPORTDiscus databases were searched from inception to April 5, 2024, for studies on SERI outcomes in JHV. Following the PRISMA/R-AMSTAR guidelines and Cochrane Handbook for Systematic Reviews of Interventions, studies were screened, and data were collected on demographics, radiographic measurements, patient-reported outcomes, and complications. A meta-analysis using random-effects models to estimate study weights was performed. Five studies comprising 153 patients (208 feet) treated with SERI met inclusion criteria. Mean age was 14.6 (±4.3) years; with 80 % female patients and a mean follow-up of 43 months. Postoperative mean hallux valgus angle improved from 26.1° (±4.8) to 10.5°(±3.5), intermetatarsal angle from 14.2° (±0.6) to 6.8 (±1.7), and distal metatarsal articular angle from 12.4° (±5.9) to 4.9° (±3.1). The American Orthopedic Foot & Ankle Society (AOFAS) scores achieved the minimal clinically important difference in all studies. Minor complications were documented without significant long-term effects. The SERI technique appears effective and safe for treating juvenile hallux valgus, leading to significant improvements in radiographic measurements and patient outcomes. LEVEL OF CLINICAL EVIDENCE: Level 3.

Keywords: Bosch; Deformity; Juvenile hallux valgus; Minimally invasive; Osteotomy; Pediatric; SERI.