Arthrodesis versus resection arthroplasty for failed hallux valgus operations

The results for 18 patients (20 feet) in whom a hallux valgus procedure had failed were reviewed. Ten patients (11 feet), with a mean age of 63 years, had correction with Keller resection arthroplasty and were observed for an average of 10 years (range, 3-15 years). The hallux valgus angle improved an average of 11 degrees +/- 3 degrees, and the intermetatarsal angle improved an average of 2 degrees +/- 1.7 degrees. Results were good in six feet, fair in four, and poor in one. Eight patients (nine feet), with a mean age of 63 years, had correction with arthrodesis and were observed for an average of 5 years (range, 2-8 years). The hallux valgus angle improved an average of 23 degrees +/- 6.9 degrees, and the intermetatarsal angle improved an average of 2 degrees +/- 3 degrees. Results were good in six feet, fair in two, and poor in one. There were differences between the two operations in terms of patient satisfaction, pain relief, appearance, and footwear. The incidence of metatarsalgia was similar for the two groups. Complications, particularly malalignment, were more common in the resection group. None of the patients required additional revision operation. Resection arthroplasty is a simple procedure and does not require cast immobilization. Resection arthroplasty and arthrodesis are reasonable options for salvage treatment of failed hallux valgus operations in older patients because good results were achieved in six of nine (67%) feet after arthrodesis and in six of 11 (54%) feet after resection.