title: [Treatment of moderate and severe hallux valgus by performing percutaneous double osteotomy of the first metatarsal bone].
abstract: OBJECTIVE
  To evaluate the clinical and radiological results in the surgical treatment of moderate and severe hallux valgus by performing percutaneous double osteotomy.
  
  
  METHODS
  A retrospective study was conducted on 45 feet of 42 patients diagnosed with moderate-severe hallux valgus, operated on in a single centre and by the same surgeon from May 2009 to March 2013. Two patients were lost to follow-up. Clinical and radiological results were recorded.
  
  
  RESULTS
  An improvement from 48.14 ± 4.79 points to 91.28 ± 8.73 points was registered using the American Orthopedic Foot and Ankle Society (AOFAS) scale. A radiological decrease from 16.88 ± 2.01 to 8.18 ± 3.23 was observed in the intermetatarsal angle, and from 40.02 ± 6.50 to 10.51 ± 6.55 in hallux valgus angle. There was one case of hallux varus, one case of non-union, a regional pain syndrome type I, an infection that resolved with antibiotics, and a case of loosening of the osteosynthesis that required an open surgical refixation.
  
  
  CONCLUSIONS
  Percutaneous distal osteotomy of the first metatarsal when performed as an isolated procedure, show limitations when dealing with cases of moderate and severe hallux valgus. The described technique adds the advantages of minimally invasive surgery by expanding applications to severe deformities.
  
  
  CONCLUSIONS
  Percutaneous double osteotomy is a reproducible technique for correcting severe deformities, with good clinical and radiological results with a complication rate similar to other techniques with the advantages of shorter surgical times and less soft tissue damage.
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital de Manises, Valencia, España. Electronic address: rdiaz@hospitalmanises.es.
authors.forename: R
authors.initials: R
authors.lastname: Díaz Fernández
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Cirugía mínimamente invasiva; Cirugía percutánea; Doble osteotomía; Double osteotomy; Hallux valgus severo; Minimally invasive surgery; Osteotomía de Reverdin-Isham; Percutaneous surgery; Reverdin-Isham osteotomy; Severe hallux valgus