Risk Factors for Postoperative Complications in Hallux Valgus Surgery: A Retrospective Cohort Study

Area of Science:

• Orthopedic Surgery
• Podiatry
• Public Health

Background:

• Hallux valgus is a prevalent forefoot deformity.
• Surgical correction offers good functional outcomes but carries risks of postoperative complications.
• Preoperative risk factors' impact on complications in the Spanish population requires comprehensive characterization.

Purpose of the Study:

• To analyze the association between preoperative risk factors and complications following hallux valgus surgery.
• To determine if the accumulation of risk factors follows a dose-response pattern for increased postoperative risk.

Main Methods:

• Retrospective observational study of 123 hallux valgus surgery patients with 12-month follow-up.
• Analysis of variables: age, sex, deformity severity, smoking, diabetes mellitus, antithrombotic therapy.
• Construction of an accumulated risk factor index and statistical analysis including multivariate logistic regression.

Main Results:

• Overall complication rate was 20.3%, including recurrence, chronic pain, joint stiffness, and infection.
• Complication frequency rose from 15.9% (no risk factors) to 50.0% (three risk factors) (p-trend = 0.038).
• Male sex (OR 5.39) and diabetes mellitus (OR 8.37) were independent predictors of higher complication risk.

Conclusions:

• Hallux valgus surgery prognosis is generally favorable, but preoperative factors significantly impact outcomes.
• Diabetes mellitus and an accumulation of risk factors are key indicators for increased postoperative risk.
• Patients with identified risk factors may benefit from enhanced preoperative assessment, metabolic optimization, and closer monitoring.