Bilateral vs unilateral correction of hallux valgus

NewsBot · Jun 25, 2015

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Efficacy of Bilateral Simultaneous Hallux Valgus Correction Compared to Unilateral
Anton Viktorovich Boychenko et al
Foot & Ankle International June 24, 2015

Background: Hallux valgus affects up to 29% of adults and can be bilateral in 84% of cases. Contemporary surgical techniques provide the possibility of simultaneous bilateral correction, but still there is no consensus on whether staged or simultaneous correction should be performed if both feet are involved. The aim of the present study was to report our experience of treatment of patients with hallux valgus and to perform comparative analysis of results obtained from unilateral and simultaneous bilateral surgical correction.
Methods: Data on 60 feet (40 patients) with hallux valgus that underwent surgery between 2010 and 2013 using scarf osteotomy and lateral soft tissue release were analyzed. Unilateral correction was performed in 30 feet (25 patients) and bilateral correction in 30 feet (15 patients). The patients from both groups were admitted to hospital for 7 days. Functional assessment (American Orthopaedic Foot & Ankle Society [AOFAS] score) and radiographic examination (intermetatarsal and hallux valgus angles) were performed preoperatively and at 6, 12, and 24 months after the procedure. Comparative analysis between groups with bilateral and unilateral correction was carried out.
Results: At 24 months after surgery in the bilateral and unilateral groups, the mean AOFAS score was 86 ± 6.2 and 86 ± 6.9 (P > .05), the mean intermetatarsal angle was 8.4 ± 0.5 and 8.8 ± 0.8 degrees (P > .05), and the mean metatarsophalangeal angle was 13.0 ± 1.2 and 13.0 ± 0.9 degrees (P > .05), respectively.
Conclusion: According to the data obtained, simultaneous bilateral correction had the same functional and radiographic results as unilateral surgery.
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NewsBot · Dec 11, 2015

PERCUTANEOUS HALLUX VALGUS TREATMENT: UNILATERALLY OR BILATERALLY
Paulo Carvalho, G. Viana, M. Flora, P. Emanuel, P. Diniz
Foot and Ankle Surgery; Article in Press

Highlights
•Similar results were obtained in patients that have been percutaneously operated on one foot and those operated on both feet at the same surgical time for mild to moderate Hallux valgus correction.
•The AOFAS score, the satisfaction rate, the complications rate and angles correction of the Reverdin-Isham osteotomy were good and similar in both, bilaterally and unilaterally operated patients.
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Introduction
Currently there is no consensus regarding the use of bilateral simultaneous percutaneous surgery for Hallux valgus treatment. Although the technique described in M. Prado's book, recommends operating only one foot at a time there are no published studies confirming it. The aim of this study was to evaluate whether there is a difference between the results of patients that have been percutaneously operated on one foot and those operated on both feet at the same surgical time for mild to moderate Hallux valgus correction.

Material/Methods
We did a retrospective single centre evaluation of 93 feet (61 patients) with Hallux valgus operated percutaneously. 29 patients were operated unilaterally (group I) and 32 bilaterally simultaneously (group II) between 2005 and 2009. The Metatarsophalangeal angle (MPA), Intermetatarsal angle (IMA) and Distal metatarsal articular angle (DMAA) were evaluated pre- and postoperatively. The AOFAS score, the degree of patients’ satisfaction and the complications were evaluated postoperatively.

Results
The mean follow-up was 24,0 months in group I, and 28,0 in group II. The average postoperative AOFAS score was 86.8, 82.9 in group I and 88.6 in group II (p > 0,05). 90,6% were satisfied or very satisfied in group I, and 89,7% in group II (p > 0,05). There was no statistically significant difference (p > 0,05) in the average correction of MPA, DMAA, and IMA. The complications rate was similar in both groups.

Conclusions
The similar results obtained in both groups suggest that the simultaneous bilateral percutaneous surgery gives equivalent results to the unilateral, which has an important socioeconomic impact since there is only one recovery time for both feet. Further research is needed.
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NewsBot · Jan 2, 2018

UNILATERAL VERSUS SIMULTANEOUS BILATERAL PERCUTANEOUS HALLUX VALGUS SURGERY
Eusebio Crespo Romero et al
Journal of Musculoskeletal Research: 28 December 2017

Introduction: The purpose of the present study is to evaluate the clinical and radiographic results of simultaneous surgical correction for bilateral hallux valgus compared with unilateral correction using percutaneous forefoot surgery techniques (PFS). Material and Methods: A prospective cohort study of 82 patients (106 feet). The mean follow-up was 58.7±±1.5 months (range 22.3 to 112.1). Patients were divided into two groups, unilateral surgical group (group U, 58 feet) and simultaneous bilateral surgical group (group B, 48 feet). Results: Preoperative mean visual analog scale (VAS) was 6.2 points in group U and 6.3 in group B (p=0.170p=0.170), at the last follow-up it decreased in both groups (1.6 group U and 1.8 group B, p=0.277p=0.277). AOFAS score improved from approximately 50 points preoperative in both groups, to 88 at the last follow-up. Mean hallux valgus angles in groups U and B changed from 34.7∘∘ and 34.3∘∘ preoperatively (p=0.838p=0.838), to 21.3∘∘ and 22.4∘∘ follow-up, respectively (p=0.635p=0.635). With the numbers available, no significant inter-group differences were observed in clinical and radiographic outcomes. Conclusions: PFS is a valid procedure for outpatient simultaneous surgical correction in patients with bilateral hallux valgus
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NewsBot · May 7, 2020

Simultaneous bilateral hallux valgus surgery: percutaneous or conventional? Early results of a matched study from a tertiary institution
Winston Shang RongLimMBBS, MRCS (Ed)Inderjeet SinghRikhrajMBBS, FRCS, (Glas)Kevin Oon ThienKooMBBS, FRCS
Foot and Ankle Surgery; 6 May 2020

Highlights
•Bilateral hallux valgus surgery is effective for patients with bilateral deformity
•Bilateral minimally invasive surgery has similar patient outcomes as open technique
•Mean post-operative hallux valgus angle is lower in the minimally invasive group
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Background
Hallux valgus is bilateral in up to 84% of cases. In the setting of simultaneous bilateral correction, we aim to evaluate if minimally invasive percutaneous surgery (MIS) provides any advantage compared to conventional open surgery.

Methods
52 feet (26 patients) undergoing simultaneous bilateral MIS surgery were matched by severity of deformity to 52 feet (26 patients) undergoing simultaneous conventional open surgery. Patients were followed for a minimum of six months. Pre- and post-operative radiographs and clinical records were reviewed.

Results
There were no significant differences in pre-operative function or pain between both groups. Post-operatively, the mean hallux valgus angle (HVA) was significantly lower in the MIS group. (HVA MIS – 8.6; Open – 11.8, P = 0.013). There were no significant differences in post-operative outcome and patient satisfaction between both groups.

Conclusion
This study demonstrates that simultaneous bilateral MIS hallux valgus surgery can be considered for patients with bilateral symptomatic hallux valgus.
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NewsBot · Jun 7, 2020

Simultaneous Bilateral Hallux Valgus Surgery: Percutaneous or Conventional? Early Results of a Matched Study From a Tertiary Institution
Winston Shang Rong Lim et al
Foot Ankle Surg. 2020 May 6

Background: Hallux valgus is bilateral in up to 84 % of cases. In the setting of simultaneous bilateral correction, we aim to evaluate if minimally invasive percutaneous surgery (MIS) provides any advantage compared to conventional open surgery.

Methods: 52 feet (26 patients) undergoing simultaneous bilateral MIS surgery were matched by severity of deformity to 52 feet (26 patients) undergoing simultaneous conventional open surgery. Patients were followed for a minimum of six months. Pre- and post-operative radiographs and clinical records were reviewed.

Results: There were no significant differences in pre-operative function or pain between both groups. Post-operatively, the mean hallux valgus angle (HVA) was significantly lower in the MIS group. (HVA MIS - 8.6; Open - 11.8, P = 0.013). There were no significant differences in post-operative outcome and patient satisfaction between both groups.

Conclusion: This study demonstrates that simultaneous bilateral MIS hallux valgus surgery can be considered for patients with bilateral symptomatic hallux valgus.
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