|Beitragstitel||Surgical Treatment Of Mild To Severe Hallux Valgus Deformities With A Percutaneus Subcapital Osteotomy Combined With A Lateral Soft Tissu Procedure|
In the surgical treatment of hallux valgus (HV), distal metatarsal (MT) osteotomies have been used in
mild or moderate cases and proximal MT osteotomy has been considered the treatment of choice for
severe deformities. A distal osteotomy could achieve a greater degree of correction by the addition of a
distal soft-tissue procedure and be used to treat also severe deformity.
Limited evidence about the use of the percutaneous subcapital osteotomy (SCOT) in combination of a soft tissue procedure, which could unify the advantages of both techniques, is available. We evaluated this procedure routinely used in our clinic.
Study Design & Methods
A total of 30 consecutive patients suffering from painful HV and treated with SCOT combined with lateral soft tissue release in our hospital from September 2012 to April 2015 were included in this retrospective review. Outcomes assessed included radiological parameters: HV angle (HVA) and intermetatarsal angle (IMA), clinical evaluation using the American Orthopaedic Foot and Ankle Society score (AOFAS) and complication rate
In 12 of the 30 patients included, the pathology was bilateral, comprising a total of 42 surgical cases analyzed. The overall correction of the angles was statistically significant (p<0.001), changing from a
HVA of 28.2o and IMA of 13.5 preoperatively to HVA of 8.0o and IMA of 6.0 postoperatively. The cases were divided into mild-moderate (34/42) and severe (8/42). Both groups showed a statistically significant correction in the angles, 3 months after surgery (p<0.001). The AOFAS score showed a median of 49 points (n=24) preoperatively and of 95 points (n=40) at the end of follow up. The complication rate at end of follow-up was 19% (8/42).
After a minimum follow-up of one year, our technique for HV correction results in great a clinically relevant improvement of the radiological parameters and AOFAS score in mild to severe deformities.
Combination with lateral release could be important a meaningful surgical alternative for the treatment of severe cases to help decrease the risk of recurrence.