title: Percutaneous Hallux Valgus Surgery Without Distal Metatarsal Articular Angle Correction.
abstract: BACKGROUND
  Many factors are considered predictors of recurrence after hallux valgus (HV) surgery, including preoperative distal metatarsal articular angle (DMAA). The restoration of the bone and joint alignment would be more important than realigning the cartilaginous surface of the metatarsal head. Therefore, is DMAA correction essential for a good clinical and radiological results after HV surgery? This study aims to illustrate the results of percutaneous forefoot surgery (PFS) for correction of HV deformity without DMAA correction.
  
  
  METHODS
  A prospective single-center study of 74 patients (89 feet), with mild-to-moderate hallux valgus deformity, who underwent PFS. The mean latest follow-up was 57.3 months.
  
  
  RESULTS
  Preoperative median visual analog scale was 7 points and AOFAS scores were 52 points. At the mean latest follow up both scores improved to 0 points and 90 points, respectively. Median HV angle and intermetatarsal angle changed from 30° and 12° preoperatively, to 21° and 11° at mean latest follow-up. Overall, 80% of the patients were satisfied or very satisfied. Recurrence of medial first metatarsal head pain occurred in 12 cases (13.5%).
  
  
  CONCLUSIONS
  PFS, without DMAA correction, is a valid procedure for surgical correction in patients with HV, despite the slightly worse radiographic results in our study.
  
  
  METHODS
  Level II: Prospective study.
authors.affiliation: Orthopaedic and Traumatology Unit (ECR, AAO, RPC, SGG, JGG, RCR).|Research Support Unit (AAA).|Hospital Mancha-Centro, Ciudad Real, Spain (AAA).
authors.forename: Eusebio
authors.initials: E
authors.lastname: Crespo Romero
authors.affiliation: Orthopaedic and Traumatology Unit (ECR, AAO, RPC, SGG, JGG, RCR).|Research Support Unit (AAA).|Hospital Mancha-Centro, Ciudad Real, Spain (AAA).
authors.forename: Alvaro
authors.initials: A
authors.lastname: Arcas Ordoño
authors.affiliation: Orthopaedic and Traumatology Unit (ECR, AAO, RPC, SGG, JGG, RCR).|Research Support Unit (AAA).|Hospital Mancha-Centro, Ciudad Real, Spain (AAA).
authors.forename: Raquel
authors.initials: R
authors.lastname: Peñuela Candel
authors.affiliation: Orthopaedic and Traumatology Unit (ECR, AAO, RPC, SGG, JGG, RCR).|Research Support Unit (AAA).|Hospital Mancha-Centro, Ciudad Real, Spain (AAA).
authors.forename: Silvia
authors.initials: S
authors.lastname: Gómez Gómez
authors.affiliation: Orthopaedic and Traumatology Unit (ECR, AAO, RPC, SGG, JGG, RCR).|Research Support Unit (AAA).|Hospital Mancha-Centro, Ciudad Real, Spain (AAA).
authors.forename: Angel
authors.initials: A
authors.lastname: Arias Arias
authors.affiliation: Orthopaedic and Traumatology Unit (ECR, AAO, RPC, SGG, JGG, RCR).|Research Support Unit (AAA).|Hospital Mancha-Centro, Ciudad Real, Spain (AAA).
authors.forename: Jaime
authors.initials: J
authors.lastname: Gálvez González
authors.affiliation: Orthopaedic and Traumatology Unit (ECR, AAO, RPC, SGG, JGG, RCR).|Research Support Unit (AAA).|Hospital Mancha-Centro, Ciudad Real, Spain (AAA).
authors.forename: Ricardo
authors.initials: R
authors.lastname: Crespo Romero
mesh_terms: D000328:Adult; D000368:Aged; D017760:Bone Malalignment / Q000517:prevention & control*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D061214:Patient Safety; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011859:Radiography / Q000379:methods; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
keywords: distal metatarsal articular angle; hallux valgus deformity; minimally invasive surgery; percutaneous surgery