Hallux valgus in men – part II: surgical treatment

Abstract

Objective: In the first part of this study, it was concluded that the hallux valgus deformity in men is hereditary, mainly transmitted by maternal genes, starts precociously and shows itself more intensely than in women. The incidence among us was 15 women for each man and the distal metatarsal articular angle (DMAA) proved to be the main intrinsic factor responsible for the expressivity of hallux valgus in the male sex. In the second part, the goal was to evaluate the response of these patients to the surgical treatment. Methods: Data from fifty feet of male patients with hallux valgus, who were surgically treated by the same surgeon between 1985 and 2005, were retrospectively analyzed. The technique was algorithmically chosen according to the intensity and complexity of the deformities. Thus, 10 chevron osteotomies, 9 biplanar chevron osteotomies, 12 Mitchell osteotomies, 9 Scarf osteotomies and 10 basilar first metatarsal osteotomies were performed. The average follow-up was 10 years (minimum of 2 and maximum of 20). Results: After analyzing the group of patients, the angular radiological parameters, the sesamoid deviation and the articular congruence prove to have had the adequate correction of the deformities due to the treatment carried out. When examining the procedures separately, it is possible to notice the balance in their corrective capacities, except for the Scarf osteotomy. The rising in the AOFAS score certified the clinical and functional improvement of the operated patients in the postoperative period. Conclusions: It was conclude that hallux valgus in the male sex was adequately corrected with the selected techniques validating the algorithm of treatment employed for both sexes. A greater difficulty or resistance to the treatment of the male hallux valgus could not be detected. The Scarf osteotomy proved to have an inferior corrective capacity than the other techniques.