Percutaneous hallux valgus surgery: a prospective multicenter study of 189 cases

Distal first metatarsal osteotomies have been indicated for the correction of mild-to-moderate hallux valgus deformity. The aim of this study was to assess the clinical and radiographic results of the distal Reverdin-Isham first metatarsal osteotomy with use of a percutaneous procedure after a minimum 1-year followup. One hundred eighty-nine feet in 168 consecutive subjects were included in the present prospective multicenter study. A radiographic and clinical assessment using the American Orthopaedic Foot and Ankle Society's (AOFAS) hallux-metatarsophalangeal-interphalangeal scale was performed for all the subjects with a minimum 1-year follow-up. One hundred fifty six subjects (87%) were satisfied or very satisfied with the outcome of the procedure. The median postoperative AOFAS score was 93 points. Subjects averaged a loss 17% of first metatarsophalangeal joint motion. The median hallux valgus angle and intermetatarsal angle improved from 28 degrees and 13 degrees preoperatively, to 14 degrees and 10 degrees postoperatively, respectively. Percutaneous correction of mild-to-moderate hallux valgus deformity with the Reverdin-Isham osteotomy of the first metatarsal enables us to achieve clinical and radiographic results comparable to other percutaneous or open distal metatarsal osteotomies after 1-year follow-up.