Percutaneous hallux valgus correction using the Reverdin-Isham osteotomy.
BACKGROUND
The present study assessed 2-year clinical and radiological results of percutaneous correction of hallux valgus by Reverdin-Isham osteotomy and sought to clarify indications for the technique.


METHODS
A continuous prospective single-center series of 104 cases of medium-to-moderate hallux valgus was managed by the same percutaneous technique, with a median 2 years' clinical and radiological follow-up (with no loss to follow-up). Uni- and multivariate analysis determined predictive factors for the mobility and degree of correction obtained.


RESULTS
American Orthopedic Foot and Ankle Society (AOFAS) functional score rose from a preoperative median of 49/100 to 87.5/100 postoperatively (p<0.05); 89% of patients were satisfied or very satisfied with their result at end of follow-up. Hallux valgus and distal metatarsal articular angle (DMAA) were significantly reduced (30 and 15 degrees to 15 and 7 degrees, respectively; p<0.05). Associated lateral ray surgery significantly increased the postoperative risk of MTP1 joint incongruence (p=0.009).


CONCLUSIONS
Percutaneous correction by Reverdin-Isham osteotomy seemed effective in isolated medium-to-moderate hallux valgus, but involves a learning curve and lacks precision in case of associated lateral metatarsal osteotomy, with a risk of DMAA hypercorrection and increased risk of MTP1 joint incongruence. Indications for percutaneous Reverdin-Isham osteotomy seem to be limited to isolated medium-to-moderate hallux valgus (M1M2 angle <15 degrees, M1P1 angle around 30 degrees) with elevated DMAA and congruent MTP1 joint.


METHODS
Level IV. Therapeutic study.
Bauer
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T
Orthopedic and Traumatologic Surgery Department, Ambroise-Paré Hospital, Paris Area West University, Boulogne, France. thomas.bauer@apr.aphp.fr
Biau
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D
Lortat-Jacob
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A
Hardy
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P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011446:Prospective Studies; D011859:Radiography; D012044:Regression Analysis; D016896:Treatment Outcome