Evaluation of hallux valgus treatment: is classical angular correction approach relevant?

Area of Science:

• Orthopedic Surgery
• Podiatry
• Radiology

Background:

• Hallux valgus correction often involves metatarsal procedures.
• The classical angular correction approach (CACA) uses intermetatarsal (IMA) and hallux valgus (HVA) angles to guide surgical method selection.
• This study compares outcomes based on adherence to the CACA strategy.

Purpose of the Study:

• To compare postoperative radiographic parameters and foot morphology between patients treated with and without the CACA strategy.
• To evaluate the effectiveness of CACA in hallux valgus correction.

Main Methods:

• A retrospective comparative study of 92 feet (92 patients) undergoing metatarsal procedures for hallux valgus.
• Patients were divided into CACA-conforming and non-conforming groups based on IMA and HVA angles.
• Evaluated parameters included radiographic angles, foot width, soft tissue measurements, AOFAS-MTP-IP scores, and Manchester scale appearance post-surgery.

Main Results:

• No significant differences were found in IMA, HVA, bony or soft tissue forefoot width, medial eminence width, or AOFAS-MTP-IP scores between groups.
• Medial soft tissue width increased in both groups.
• Improved foot appearance on the Manchester scale was observed in 77.6% of the CACA-conforming group versus 55.9% in the non-conforming group (p=0.029).

Conclusions:

• The CACA strategy, which tailors procedures to deformity severity, did not significantly impact postoperative radiographic parameters.
• Adherence to the CACA strategy appears to improve the morphologic appearance of the foot after hallux valgus surgery.