Pain assessment in hallux valgus surgery: A comparison between minimally invasive transverse osteotomy and akin...

Hallux valgus is associated with pain, functional limitation and reduced life quality. Percutaneous surgical techniques with multimodal analgesia have emerged as alternatives to conventional approaches. Some studies suggest that percutaneous techniques result in less pain than open surgery.

To compare rescue analgesic use and postoperative pain between the Scarf and META techniques in patients undergoing hallux valgus surgery.

A prospective cohort comprising two matched groups of patients who underwent hallux valgus surgery with either the Scarf or META technique was conducted. The same anesthetic and analgesic protocol was used in both groups. Pain was assessed using the Visual Analog Scale (VAS). Surveys were administered daily from postoperative day 1 to 7 and weekly from the second to the sixth week. Rescue analgesia (opioids) was also recorded.

53 patients were enrolled: 28 in the META and 25 in the Scarf osteotomy group; demographic data were similar between groups. On postoperative day 1, VAS pain was 0.5 (0-2) in the META group and 2 (0-5) in the Scarf group. On day 2, it was 1 (0-2) and 7.1,^3-10 respectively. By week 6, pain were similar in both groups. Opioid use was higher in the open group. Differences in pain and analgesic use were statistically significant (p < 0.05).

The percutaneous group required lower doses of analgesia and reported less pain than the open technique, particularly during the first two postoperative weeks.