Tendon balancing in hallux valgus surgery.

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery
• Biomechanics

Background:

• Recurrent hallux valgus after surgery is a complication often linked to tendon imbalance.
• The extensor hallucis longus (EHL) tendon is frequently implicated due to maltracking, especially in cases of tight Achilles tendons.
• Existing literature on this specific complication and its surgical management is limited.

Purpose of the Study:

• To investigate the role of tendon balancing in preventing hallux valgus recurrence.
• To evaluate the efficacy and safety of tendon realignment and lengthening procedures for hallux valgus.
• To assess the impact of tendon balancing on foot strength and walking ability.

Main Methods:

• A perioperative evaluation was conducted on 10 patients with severe hallux valgus post-osteotomy and capsular closure.
• Tight extensor or flexor tendons of the hallux exhibiting residual valgus maltracking were identified.
• A tendon balancing procedure involving realignment and lengthening was performed on affected tendons.

Main Results:

• All 10 patients achieved good clinical outcomes following tendon balancing.
• No adverse effects were reported, and tendon strength remained at least 3+ in all patients, except one with multiple sclerosis.
• Patients did not report any walking difficulties or weakness after the procedure.

Conclusions:

• Tendon balancing, including realignment and lengthening, appears to be an effective method for preventing hallux valgus recurrence.
• This surgical technique can be performed safely without negatively impacting patient strength or gait.
• Addressing tendon imbalance is a crucial consideration in managing hallux valgus and preventing post-operative complications.