Intramedullary locking plates device versus headless screw fixation for treatment of hallux valgus deformity: A...

This retrospective observational study aimed to evaluate the outcomes of subcapital osteotomy using an intramedullary locking plate for the treatment of hallux valgus (HV) deformity. We hypothesized that plate fixation would provide superior angular correction and lower recurrence compared to screw fixation. Between January 2018 and July 2023, a total of 49 feet underwent corrective osteotomy for HV. Of these, 36 feet were treated with headless screws and 13 with intramedullary locking plates. All cases had a minimum follow-up duration of 12 months. Radiographic outcomes were assessed using weight-bearing radiographs obtained preoperatively and at 1, 6, and 12 months postoperatively. The mean follow-up duration was 24.64 ± 14.34 months in the screw group and 18.23 ± 8.47 months in the plate group. HV recurrence was observed in 9 feet - 7 (77.78%) in the screw group and 2 (22.22%) in the plate group (P = 1.000). The findings demonstrate that subcapital osteotomy with an intramedullary locking plate is effective in correcting the intermetatarsal angle, particularly when compared to the use of headless screws in modified Mitchell osteotomy. Furthermore, precise adjustment of the plate tip position allowed for effective correction of significant deviations in the distal metatarsal articular angle. Three cases of loss of reduction were observed in the screw group, while the plate group experienced minimal complications. Longer-term follow-up data are required to provide a more accurate and comprehensive assessment of clinical outcomes.