Recurrence of hallux valgus is one of the most common and difficult complications after surgery. Due to the lack of understanding of 3D deformity of hallux valgus and risk factors for recurrence, the overall recurrence rate is still high, and the choice of treatment is still controversial. Improper operation and severe deformity are known risk factors for recurrence, while the role of unstable of the first plantar train and combined flat foot deformity in the recurrence has been paid more attention by scholars at home and abroad. In addition to the first metatarsophalangeal fusion, modified Lapidus osteotomy and proximal metatarsal osteotomy have been proven to be reliable revision procedures. The purpose of this study is to summarize risk factors for recurrence of hallux valgus after surgery, and to explore the choice of revision surgery after recurrence, in order to provide guidance for prevention and management of recurrence of hallux valgus.
Bunion/surgery* ; Hallux Valgus/surgery* ; Humans ; Radiography ; Reoperation ; Risk Factors

Bunion ; Hallux Valgus/surgery* ; Humans ; Minimally Invasive Surgical Procedures/methods*

The expert consensus of the third-generation minimally invasive technical specification for hallux valgus was developed by Foot and Ankle Committee of Orthopaedic Branch of Chinese Medical Doctor Association, Foot and Ankle Committee of Sports Medicine Branch of Chinese Medical Doctor Association, and Foot and Ankle Expert Committee of Orthopedic Branch of Chinese Association of Integrative Medicine. The consensus was drawn from evidence-based medicine and experts' clinical experience to provide an academic guidance of the third-generation minimally invasive technical specification of hallux valgus for the orthopedic surgeons, including definition, indications, osteotomy techniques, post-operative rehabilitation and prognosis.
Bunion ; Consensus ; Hallux Valgus/surgery* ; Humans ; Orthopedics ; Osteotomy/methods*

Humans ; Hallux Valgus/surgery* ; Orthopedic Procedures ; Bunion/surgery* ; Joint Diseases/surgery* ; Treatment Outcome

OBJECTIVE: To compare minimally invasive and traditional Chevron osteotomy in treating patients with mild to moderate hallux valgus. METHODS: Clinical data of 36 patients (36 feet) with mild to moderate hallux valgus from January 2019 to February 2021 were retrospectively analyzed, and divided into minimally invasive osteotomy(minimally invasive group) and traditional Chevron osteotomy(traditional group). There were 16 patients in minimally invasive group, including 1 male and 15 females, aged from 36 to 60 years old with an average of(49.0±9.5) years old;9 were mild and 7 were moderate according to Mann classification;treated with minimally invasive osteotomy with hollow screw fixation. There were 20 patients(20 feet) in traditional group, including 2 males and 18 females, aged from 38 to 65 years old with an average of(50.0±9.2) years old;11 were mild and 9 were moderate according to Mann classification;treated with traditional Chevron osteotomy. Hallux valgus angle (HVA), intermetatarsal angle (IMA) before and after operation at 12 months bewteen two groups were observed and compared, and American Orthopedic Foot and Ankle Society (AOFAS) forefoot score and visual analogue scale (VAS) before and after operation at 6 weeks and 12 months between two groups were compared. RESULTS: Thirty-six patiens were followed up from 14 to 30 months with an average of (21.00±5.77) months. All incisions were healed well at stageⅠwithout infection. There were no significant differences in HVA, IMA, AOFAS forefoot scores and VAS before and after operation at 12 months between two groups(P>0.05). However, AOFAS forefoot scores and VAS of minimally invasive group was significantly better than that of traditionl group at 6 weeks after operation (P<0.05). Postoperative HVA, IMA, AOFAS forefoot scores and VAS at 12 months bewteen two groups were improved better than that of preoperation(P<0.05). CONCLUSION Compared with traditional Chevron osteotomy, minimally invasive osteotomy has less trauma and quicker recovery. Both of them has similar clinical effects, and could receive satisfactory clinical effects, while treatment of minimally invasive osteotomy should pain attention to learning curve.
Adult ; Aged ; Bunion ; Female ; Hallux Valgus/surgery* ; Humans ; Male ; Middle Aged ; Osteotomy ; Retrospective Studies ; Treatment Outcome

Humans ; Bunion/complications* ; Hallux Valgus/surgery* ; Metatarsal Bones ; Metatarsophalangeal Joint ; Gout ; Synovitis

OBJECTIVE: To explore short-term results of minimally invasive Chevron osteotomy with lateral soft tissue release in treating mild to moderate hallux valgus. METHODS: Sixty patients (80 feet) with mild to moderate hallux valgus treated with minimally invasive Chevron osteotomy with lateral soft tissue release from January 2019 to December 2021 were retrospectively analyzed. Among them, there were 5 males (6 feet) and 62 females (74 feet), aged from 20 to 60 years old with an average of (47.2±9.7) years old;54 patients (64 feet) with mild hallux valgus, and 13 patients(16 feet) with moderate hallux valgus. Hallux valugs angle(HVA), Ⅰ-Ⅱ intermetatarsal anlge(Ⅰ-Ⅱ IMA), distal metatarsal articular angle(DMAA)and sesamoid Hardy score were compared before and after operation, and American Orthopaedic Foot and Ankle Society's Hallux Metatarsophalangeal- Interphalangeal (AOFAS Hallux MTP-IP) scale was used to evaluate clinical effects. RESULTS: Sixty-seven patients (80 feet) were followed-up from 6 to 23 months with an average of (13.7±6.5) months. Preopertive HVA, Ⅰ-Ⅱ IMA, DMAA, sesamoid Hardy score and AOFAS Hallux MTP-IP were (27.5±7.0)°, (17.4±4.1)°, (11.4±3.8)°, (4.9±2.6) and (58.2±9.1), respectively;while at the final follow up were(8.3±4.8)°, (6.9±3.0)°, (3.9±2.4)°, (2.7±1.1) and(91.3±2.2);and there were statistical differences between pre-operation and the latest follow-up(P<0.05). There were differences in preopertaive imaging indexes and AOFAS Hallux MTP-IP between 64 mild and 16 moderate hallux valgus feet(P<0.05);while no difference in above indexes at the final follow-up(P>0.05);from the view of degree of improvement, HVA, Ⅰ-Ⅱ IMA, sesamoid Hardy score and AOFAS Hallux MTP-IP in moderate hallux valgus were better than that of in mild hallux valgus(P<0.05). Four patients occurred redness and swelling around incision on the osteotomy site, and cured by local dressing change and oral antibiotics. CONCLUSION Minimally invasive Chevron osteotomy combined with lateral soft tissue release has advantages of correction and functional improvement for mild to moderate hallux valgus.
Adult ; Bunion ; Female ; Hallux Valgus/surgery* ; Humans ; Male ; Middle Aged ; Osteotomy/methods* ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVE: To explore clinical effect of Scarf osteotomy combined with soft tissue balance in treating severe hallux valgus. METHODS: Totally 38 patients(50 feet) with severe hallux valux who underwent Scarf osteotomy combined with soft tissue balance surgery from June 2019 to June 2021 were retrospectively analyzed, aged from 29 to 64 years old with an average of(54.7±6.8) years old; 26 feet on the left side and 24 feet on the right side;the courses of disease ranged from 5 to 23 years with an average of (12.4±3.9) years. Hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) were compared before and after operation, and postoperative complications was observed. American orthopedic foot ankle society(AOFAS) score before operation and final follow-up was used to evaluate recovery of forefoot function, and visual analogue scale (VAS) was used to evaluate pain relief. RESULTS: Thirty-eight patients (50 feet) were followed up from 15 to 23 months with an average of (18.3±3.2) months. Preoperative HVA, IMA and DMAA were (44.61±3.92)°, (18.74±2.51)°, (12.85±2.11)°, and improved to (13.45±2.13)°, (7.83±1.36)°, (7.03±1.39)°at final follow-up, which had statistical differneces(P<0.05). No delayed union or nonunion of osteotomy end, fracture or loosening of internal fixation, hallux varus occurred. VAS and AOFAS score improved from (6.81±2.14), (43.6±8.4)points before operation to (1.97±0.78), (87.6±5.2) points at final follow-up, which had statistical difference(P<0.01). According to AOFAS at final follow-up, 20 feet got excellent result, 28 feet good and 2 feet moderate. CONCLUSION Scarf osteotomy combined with soft tissue balance release for severe hallux valgus has good stability and corrective effect, but learning curve and postoperative complications should be paid attention.
Adult ; Humans ; Middle Aged ; Bunion ; Hallux Valgus/diagnostic imaging* ; Metatarsal Bones/surgery* ; Osteotomy ; Postoperative Complications ; Radiography ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To explore clinical effect of the first metatarsophalangeal joint fusion combined with lateral toe rotation Weil osteotomy in treating hallux valgus with severe metatarsal adduction. METHODS: From March 2017 to August 2021, 37 patients ( 69 feet ) with severe plantar adductor hallux valgus were treated with the first metatarsophalangeal joint fusion combined with rotational Weil osteotomy were retrospectively analyzed, including 8 males(11 feet) and 29 females (58 feet), aged from 67 to 83 years old with an average of (70.03±2.87) years old;3 cases on the left side, 2 cases on the right side and 32 cases on both sides. Visual analogue scale(VAS) was used to evaluate degree of pain relief before operation, 6 weeks after operation and at the final follow-up. American Orthopaedic Foot and Ankle Surgery (AOFAS) forefoot score was used to evaluate function of the affected foot before operation and final follow-up. Hallux valgus angle(HVA) and intermetatarsal angle(IMA) were measured before operation and at the final follow-up. RESULTS: Thirty-seven patients(69 feet) were followed up from 12 to 48 months with an average of(22.8±0.6) months. Bone healing was achieved at the first metatarsophalangeal joint from 7 to 10 weeks with an average of (8.00±1.21) weeks after operation, without delay and nonunion. HVA was increased from (44.30±2.84)° before operation to (15.20±2.13) °at the final follow-up, and had statistical difference(t=65.781, P<0.05);while no difference in IMA before and after operation(P>0.05). VAS was decreased from (6.73±1.48) points to (2.78±0.71) points at 6 months after operation(t=3.279, P<0.05), and had difference compared with the latest follow-up(1.16±1.12)(t=4.859, P<0.05). AOFAS forefoot score increased from (52.14±5.78) preoperatively to (86.70±4.86) at the fonal follow-up, and 25 feet got excellent results, 40 feet good and 4 feet fair. CONCLUSION The first metatarsophalangeal joint fusion combined with lateral toe rotation Weil osteotomy in treating severe plantar adduction hallux valgus could significantly relieve pain and appearance of forefoot, stabilize the first sequence, and significantly improve walking function.
Male ; Female ; Humans ; Aged ; Aged, 80 and over ; Metatarsal Bones/surgery* ; Hallux Valgus/surgery* ; Retrospective Studies ; Rotation ; Treatment Outcome ; Osteotomy/methods* ; Metatarsophalangeal Joint/surgery* ; Bunion ; Toes

OBJECTIVETo study therapeutic effects of capsulitis of little toe treated with minimal incisional osteotomy and manipulations procedures.

METHODSFrom 2003.7 to 2008.6, 90 patients (160 feet) with capsulitis of little toe including 3 male (5 foot) and 87 female (155 foot) ranging in age from 17 to 76 years(average of 49.2 years).The average medical history was 10.1 years ranging from 1 to 32 years. All patients with capsulitis of little toe were treated with minimal incisional osteotomy and manipulations procedures adopting the modified Coughlin standard to evaluation.

RESULTSAll patients were followed up, the duration of follow-up raunged from 3 to 36 months with averagement of 15.7 months. According to the modified Coughlin standard, 80 cases obtained an excellent result, 8 good, 2 fair and 0 poor, the effective rate was 97.8%. However,two patients were found delayed union after operation, the distal fragments healed following the time of fixation were delayed.

CONCLUSIONThe treatment of capsulitis of little toe with minimal incisional osteotomy and manipulations procedures is easy to operate and its therapeutic effect is convincing.

Adolescent ; Adult ; Aged ; Bunion, Tailor's ; surgery ; Female ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Minimally Invasive Surgical Procedures ; Osteotomy ; methods ; Toes ; surgery