Percutaneous hallux valgus treatment: Unilaterally or bilaterally.
BACKGROUND
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.


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.
Department of Orthopaedics and Trauma, Santana Hospital, Lisbon, Portugal 1- Chief of Foot & Ankle Surgery Department, Santana Hospital, Lisbon, Portugal; Chief of Foot & Ankle Surgery Department, Santana Hospital, Lisbon, Portugal. Electronic address: carvalho.paulo1@gmail.com.
Paulo
P
Carvalho
Department of Orthopaedics and Trauma, Santana Hospital, Lisbon, Portugal 1- Chief of Foot & Ankle Surgery Department, Santana Hospital, Lisbon, Portugal.
G
G
Viana
Department of Orthopaedics and Trauma, Santana Hospital, Lisbon, Portugal 1- Chief of Foot & Ankle Surgery Department, Santana Hospital, Lisbon, Portugal.
M
M
Flora
Department of Orthopaedics and Trauma, Santana Hospital, Lisbon, Portugal 1- Chief of Foot & Ankle Surgery Department, Santana Hospital, Lisbon, Portugal.
P
P
Emanuel
Resident.
P
P
Diniz
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006215:Hallux Valgus / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D061646:Operative Time; D010027:Osteotomy / Q000379:methods*; D010149:Postoperative Pain / Q000503:physiopathology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011859:Radiography / Q000379:methods; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
Bilateral or unilateral; Hallux valgus; Minimally invasive; Percutaneous foot surgery; Reverdin-Isham osteotomy