Surgical treatment of hallux valgus: the Gibson-Piggott technique revisited

More than 130 surgical procedures have been described to treat hallux valgus deformity. The "spike" first distal metatarsal osteotomy was first described by Gibson and Piggott in 1962. Despite having the advantage of using only patient's "material", this technique has been abandoned by most orthopaedic surgeons, due to fear of complications such as breaking of the bony peg and loosening of fixation at the osteotomy site. A group of surgeons at our hospital have performed 422 Gibson-Piggott procedures between 1985 and 2005 with consistently good results. This fact convinced us to "revisit" the procedure. Thirty seven consecutive patients (43 feet) who had surgery between July 2000 and December 2002 were randomly selected as "sample". A Questionnaire based on the American Orthopaedic Foot and Ankle Society (AFOS) Score was used for evaluation. Thirty three patients (36 feet), i.e. 89% responded to our survey. Average follow-up after surgery was 47 months (between 31 and 63 months). Results showed that 30 patients (91%) had no or only mild pain, 29 patients (88%) had no or only slight limitation in activities of daily living and 31 patients (94%) were able to use fashionable or comfortable shoes with no problems. When using numerical evaluation, 28 patients (85%) scored 65 or more points (from a total of 95 points), representing a good postoperative result, comparable with other "modern" distal metatarsal osteotomies. In conclusion, the Gibson-Piggott procedure was shown to be a valuable technique in the treatment of mild or moderate hallux valgus deformity.