Proximal Articular Set Angle Correction with the Reverdin-Isham Osteotomy in Mild and Moderate Hallux Valgus: A...

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery
• Surgical Techniques

Background:

• Hallux valgus is a common foot deformity requiring effective surgical correction.
• The Reverdin-Isham osteotomy is a minimal incision technique indicated for hallux valgus, particularly with elevated proximal articular angle.
• The clinical efficacy of this specific osteotomy technique requires further scientific validation.

Purpose of the Study:

• To systematically evaluate the effectiveness of the Reverdin-Isham osteotomy for hallux valgus.
• To assess radiological angle correction (PASA, IMA, HVA), functional improvement (AOFAS scale), pain reduction, and patient satisfaction.
• To identify the frequency and nature of complications associated with the procedure.

Main Methods:

• Systematic review adhering to PRISMA guidelines.
• Inclusion of ten studies encompassing 579 procedures in 500 patients with an average follow-up of 33.8 months.
• Analysis of radiological outcomes, functional scores, pain levels, and patient-reported satisfaction.

Main Results:

• Significant improvement observed in the Hallux Valgus Angle (HVA) (p=0.0009) and AOFAS scale score (+37.4 points).
• A notable reduction in pain (5.4 points) and high patient satisfaction (89.3%) were reported.
• No significant improvement in PASA (p=0.14) or IMA (p=0.05) was found, though meta-regression showed significance for IMA (p=0.0022).
• Twenty major complications were reported, with recurrences being the primary concern.

Conclusions:

• The Reverdin-Isham osteotomy is a safe and effective surgical option for mild-to-moderate hallux valgus.
• The procedure leads to significant functional gains and pain relief, with high levels of patient satisfaction.
• Recurrence is the main complication, but its low incidence supports the technique's validity for specific hallux valgus deformities.