A Systematic Review of Open and Minimally Invasive Surgery for Treating Recurrent Hallux Valgus

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery

Background:

• Hallux valgus (HV) recurrence necessitates revision surgery, yet literature on specific techniques is limited.
• High complication rates (up to 50%) are reported following primary hallux valgus correction.
• Significant reoperation rates persist despite advancements in primary surgical techniques.

Purpose of the Study:

• To evaluate and compare open and minimally invasive surgical (MIS) techniques for hallux valgus recurrence.
• To synthesize current literature on surgical methods for hallux valgus revision.

Main Methods:

• A comprehensive literature search was conducted in December 2020 using PubMed, EMBASE, and MEDLINE.
• Ten studies, encompassing 273 patients and 301 feet, were included for data synthesis.
• Data on open and MIS revision techniques for hallux valgus were analyzed.

Main Results:

• Minimally invasive surgery (MIS) was used in 80 of 301 (26.6%) revision cases, often involving distal metatarsal osteotomies.
• MIS revisions yielded a higher average improvement in American Orthopaedic Foot and Ankle Society (AOFAS) scores (38.3) compared to open techniques (26.8).
• MIS techniques resulted in greater postoperative reductions in intermetatarsal angle (5.6°) and hallux valgus angle (18.4°) than open techniques (15.5° and 4.4°, respectively).

Conclusions:

• Minimally invasive surgery (MIS) techniques for hallux valgus revision demonstrate comparable safety and outcomes to open techniques.
• MIS approaches may offer superior functional and radiographic improvements in hallux valgus revision surgery.
• Further research is needed to address limitations in the current literature regarding MIS techniques for hallux valgus recurrence.