Reverdin-Isham modified vs MICA for moderate hallux valgus: A comparative study

Abstract

Objective: To compare clinical, functional, and radiographic results of the modified minimally invasive Reverdin-Isham (RImod) and minimally invasive Chevron-Akin (MICA) techniques in the treatment of moderate hallux valgus. Methods: Retrospective comparative study of 81 feet (38 MICA, 43 RImod) with moderate hallux valgus (IMA ≤ 18°, HVA ≤ 40°). Preand postoperative evaluations (6 months) included the AOFAS score, intermetatarsal angles (IMA) and hallux valgus angle (HVA), and fibular sesamoid subluxation (FSS). Statistical analysis used Student’s t and Wilcoxon’s tests, with adjustment for bilateral testing. Results: Both groups demonstrated significant improvement (p < 0.001) in AOFAS (MICA: 37.9 ± 12.6 to 90.95 ± 8.1; RImod: 40.47 ± 13.1 to 93.4 ± 6.5), IMA (MICA: 14.9 ± 2.1° to 10.0 ± 3.0°; RImod: 14.4 ± 2.1° to 10.0 ± 2.8°), HVA (MICA: 31.3 ± 6.1° to 11.8 ± 5.7°; RImod: 29.0 ± 5.8° to 11.0 ± 4.4°) and FSS (MICA: 89% to 53%; RImod: 82% to 51%). There was no statistically significant difference between the techniques for functional gain (p = 0.98), IMA correction (p = 0.43), HVA (p = 0.30), or FSS (p = 0.41). The complication rate was 21.1% for MICA and 9.3% for RImod (p = 0.149), with different profiles: MICA presented problems with implants and recurrence, while RImod had cases of nerve injury and malunion. Conclusion: RImod and MICA are effective for the correction of moderate hallux valgus, with comparable clinical and radiographic results. Both techniques demonstrated significant clinical and radiographic improvements, with functional gains in AOFAS score and substantial angular corrections in HVA, IMA, and FSS. Level of Evidence III; Comparative Retrospective Study.