Failed Hallux Valgus surgery

NewsBot · Oct 2, 2012

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FAILED HALLUX VALGUS SURGERY
G.E. Wells, R. Haene, B. Ollivere and A. H. N. Robinson
J Bone Joint Surg Br 2012 vol. 94-B no. SUPP XLIII 11

Aim We aim to explore the reasons behind long term failure of hallux valgus surgery.

Patients & Methods A series of patients with problems following failed hallux valgus surgery presenting to a tertiary referral unit is presented. There were 47 patients with 55 problematic feet, 45 were female. The mean age was 59 years (Range 25–79). The failed bunions were compared to a prospectively collected series of 80 patients with successful 1st metatarsal osteotomies, 40 ludloff and 40 scarf osteotomies.

Before the index surgery, all the patients in the failed group, the predominant symptom was pain. Only 53% admitted deformity was an issue. A wide spectrum of procedures were performed, 13 Wilson's, 11 Keller's, 8 Chevron, 3 Bunionectomy, 2 Scarf, 1 Basal and 1 Mitchell's. In 16 patients the original procedure was unknown. The mean time to developing problems was 9.4 years (Range 0–45) with mean time to presentation 13.6 years. (Range 0–47) Radiographs revealed 2/3 of patients had relative shortening of the first metatarsal. Over 80% of x-rays demonstrated evidence of degenerative change. The mean AOFAS score deteriorated with increased shortening.

The failed bunions had statistically significantly different AOFAS pain scores (15.1 vs 31.9 p < 0.05), function scores (25.02 vs 31.9 p < 0.05). Additionally, the hallux valgus angle was significantly higher (24 vs 11.7 p < 0.05) although there was no change in DMMA between the two groups (13 vs 7.6 p > 0.05). There was a significantly higher incidence of first ray shortening (12% vs 0% p < 0.05).

Discussion This represents an unusual series, with nothing similar in the literature. Problems following hallux valgus surgery do not present for over 10 years. Functional Scores deteriorate with increasing shortening. MTPJ degeneration is common and from our data we are unable to explain why.
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Admin2 · Oct 2, 2012

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NewsBot · Sep 26, 2018

Unfavorable Outcomes Following Surgical Treatment of Hallux Valgus Deformity: A Systematic Literature Review
Barg, Alexej et al
JBJS: September 19, 2018 - Volume 100 - Issue 18 - p 1563-1573

Background: Surgical correction of deformity plays a central role in the treatment of hallux valgus deformity. However, complications or unintended outcomes are frequently noted in clinical series. There has been no rigorous systematic review of studies reporting outcomes of surgical treatment for hallux valgus deformity, to the best of our knowledge.

Methods: We performed a systematic review of studies reporting the outcomes of surgical correction for hallux valgus deformity.

Results: A total of 229 studies met the inclusion criteria. The pooled rates of postoperative patient dissatisfaction and postoperative first metatarsophalangeal pain were 10.6% and 1.5%, respectively. The overall rate of recurrent deformity was 4.9%.

Conclusions: Hallux valgus surgery has been reported to have fairly consistent results and rates of complications or unfavorable outcomes.

Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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NewsBot · Oct 3, 2018

Is Generalized Ligamentous Laxity a Prognostic Factor for Recurred Hallux Valgus Deformity?
Byung-Ki Cho, MD, PhD, Seung-myung Choi, MD
AOFAS Annual Meeting 2018 1

Introduction/Purpose: It is still unclear whether generalized ligamentous laxity is a risk factor for recurred hallux valgus
deformity. This study was performed to evaluate the intermediate-term clinical outcomes after proximal chevron osteotomy for
hallux valgus in patients with generalized ligamentous laxity, and to determine the effect on postoperative recurrence of deformity.
Methods: A total of 198 feet from 169 female patients were treated with a proximal chevron osteotomy for hallux valgus with a
mean follow-up of 46.3 months. When generalized ligamentous laxity was defined as Beighton score ≥ 5 points, there were 18
patients (10.7%) in laxity group and 151 patients (89.3%) in non-laxity group. Clinical evaluation consisted of the American
Orthopaedic Foot and Ankle Society (AOFAS) scores, Foot and Ankle Ability Measure (FAAM), and radiographic measurement of
hallux alignment. Risk factors associated with postoperative recurrence were evaluated using univariate analysis.
Results: Recurrence rates were 21.7% in the laxity group and 17.1% in non-laxity group (p = 0.218), when defined as hallux valgus
angle ≥ 20°. No significant differences of measurement at final follow-up were found between the 2 groups in terms of AOFAS
score, FAAM, recurrence rate, hallux valgus angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angle
(DMAA). Preoperative HVA and IMA were found to be predictive factors of recurrence (OR = 6.3, 4.2; P = .001, .018,
respectively).
Conclusion: There were no statistical differences in the clinical and radiographic outcomes between hallux valgus with and
without generalized ligamentous laxity. Generalized ligamentous laxity demonstrated no definitive effects on postoperative
recurrence of hallux valgus deformity.
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Failed Hallux Valgus surgery

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Failed Hallux Valgus surgery

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

plantar fibromatosis and failed cheilectomy (hallux rigidus)

failed Cartiva

Judgment for podiatrist who failed to keep records affirmed

Failed flatfoot reconstruction

Failed chiellectomy

Failed Cheilectomy

Failed Kidner..... Now what?

Share This Page

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