A Systematic Review of Open and Minimally Invasive Surgery for Treating Recurrent Hallux Valgus

Abstract

Background Despite advancements in primary correction of hallux valgus (HV), significant rates of reoperation remain across common techniques, with complications following primary correction up to 50% according to some studies.1 This study explored different methods of surgery currently used in treating HV recurrence specifically (for which literature on the subject has been limited), evaluating open and adapted minimally invasive surgical (MIS) primary techniques used for revision. Methods In December 2020, literature search for both open and MIS surgical techniques in HV revision was conducted using PubMed, EMBASE, and MEDLINE library databases. Results and Conclusion Of initial 143 publications, 10 were finally included for data synthesis including 273 patients and 301 feet. Out of 301 feet, 80 (26.6%) underwent revision with MIS techniques (involving distal metatarsal osteotomies). Those undergoing grouped MIS revisions had an average improvement of 38.3 in their American Orthopaedic Foot and Ankle Society score, compared to 26.8 in those using open techniques. Revision approaches using grouped MIS techniques showed a postoperative reduction in intermetatarsal angle and HV angle of 5.6 and 18.4 degrees, respectively, compared to 15.5 and 4.4 degrees, respectively, for open techniques. There are, however, limitations in the current literature on MIS techniques in revision HV surgery specifically. MIS techniques grouped did not show worse outcomes or safety concerns compared to open techniques.

Temporal Changes in Clinical Outcomes after Minimally Invasive Surgery for Hallux Valgus Correction in Women without Postoperative Complications

“…However, both MOXFQ and AOFAS have been shown to be highly responsive to clinical changes in the context of HV surgery [ 32 ]. These questionnaires are most commonly used to assess clinical results after HV correction [ 7 , 14 , 18 , 49 , 50 ]. Moreover, unlike the AOFAS and MOXFQ, other widely used tools, such as the Short Form 36 questionnaire, have proven to be neither reliable nor responsive enough to detect real changes after forefoot surgery [ 25 ].…”

“…Most procedures are performed using open techniques, but in the last two decades, percutaneous and minimally invasive surgery (MIS) approaches tended to be used. Their theoretical advantages include smaller scars, less postoperative pain, rapid recovery, reduced rehabilitation time, and decreased risk of infection [ 4 , 5 , 6 , 7 , 8 ]. Concerns regarding MIS use include a difficult learning curve, imprecise results, the necessity of fluoroscopy, higher economic costs, and an increased frequency of cutaneous complications [ 6 , 8 , 9 ].…”

“…Due to the difficulties in keeping the reduction after the correction, there is a tendency to fix the osteotomy with percutaneous screws [ 11 , 12 ] or with a more sophisticated minimally invasive intramedullary nail device (MIIND) [ 13 ]. Despite initial concerns regarding the reproducibility of surgical outcomes, current MIS and open techniques offer similar clinical and radiological results [ 7 , 14 , 15 , 16 , 17 , 18 , 19 ].…”

Minimal Implant Fixation in Correction Deformity of Hallux Valgus and Hammer Toe with Lapidus Procedure and Distal Chevron Technique – A Case Report

“…Minimally invasive (MIS) surgery and rotational deformity correction methods such as the Lapidus and Chevron procedures are becoming increasingly popular. As a surgeon, you should investigate current therapeutic approaches for recurrent Hallux Valgus and their outcomes [5]. The primary goal of this case report is to go over hallux valgus and hammer toe treatment using Lapidus arthrodesis and distal chevron osteotomy.…”