Ambulatorial halux valgus percutaneous surgery

Abstract

Introduction: Hallux Valgus (HV) is a frequent deformity of the foot, with multifactorial etiology and Percutaneous Foot Surgery (CPP) has been gaining enthusiasts in its treatment. Objective: Description of the surgical technique and retrospective descriptive study with clinical, functional and radiological evaluation of patients submitted to CPP by HV. Methods: All patients with HV submitted to CPP by the same surgeon, in ambulatory surgery, between May 2008 and March 2015, in an Institution. Average follow-up: 54 months (12-93 months). Obtained epidemiological variables, surgical time and surgical technique used. Radiological evaluation: Metatarsophalangeal (MTF), Intermetatarsal (IMA) and Distal Metatarsal Articular (DMA) angles. Recorded complications, recurrence rate, and reoperation. Functional evaluation: Score AOFAS-Hallux. Results: Total sample: 74 patients - 89 feet. Average age: 48 years (17-75 years). Surgical technique: Exostosectomy, Ishan-Riverdin and Akin Osteotomies and Abductor 1st finger Tenotomy in 38 cases. Associated Weil osteotomies in 51 cases. Preoperative angles MTF, ITM and DMA: 30.7º (20-46º), 11.4º (6-17º) and 25.9º (5-49º), respectively. Postoperative angles MTF, ITM and DMA: 15.3º (7-28º), 9º (5-16º) and 18º (6-35º). All osteotomies were consolidated at 3 months, except in 2 patients. Reoperation rate: 13%, 3 recurrences (3%), 5 transfer metatarsalgia (6%), one deep infection (1%) and 3 metatarsophalangeal exostosis (3%). Score AOFAS-Hallux (41 patients): 85 points (52-100 points). Conclusions: In our study, CPP proved to be a valid and safe method, with good clinical, functional and radiological results in the short and medium follow-up.