Correction method for moderate and severe degrees of hallux valgus associated with transfer metatarsalgia

Zhanaspayev A. Bokembayev N. Zhanaspayev M. Tlemissov A. Aubakirova S. Prokazyuk A.
2024 Baishideng Publishing Group Inc

World Journal of Orthopedics
2024 #15 Issue 3 238 - 246 pp.

BACKGROUND Hallux valgus (HV) is a common foot deformity that manifests with increasing age, especially in women. The associated foot pain causes impaired gait and decreases quality of life. Moderate and severe HV is a deformity that is characterized by the involvement of lesser rays and requires complex surgical treatment. In this study, we attempted to develop a procedure for this condition. AIM To analyse the treatment results of patients who underwent simultaneous surgical correction of all parts of a static forefoot deformity. METHODS We conducted a prospective clinical trial between 2016 and 2021 in which 30 feet with moderate or severe HV associated with Tailor’s bunion and metatarsalgia were surgically treated via a new method involving surgical correction of all associated problems. This method included a modified Lapidus procedure, M2M3 tarsometatarsal arthrodesis, intermetatarsal fusion of the M4 and M5 bases, and the use of an original external fixation apparatus to enhance correction power. Preoperative, postoperative, and final follow-up radiographic data and American Orthopaedic Foot and Ankle Society (AOFAS) scores were compared, and P values < 0.05 were considered to indicate statistical significance. RESULTS The study included 28 females (93.3%) and 2 males feet (6.7%), 20 (66.7%) of whom had a moderate degree of HV and 10 (33.3%) of whom had severe deformity. M2 and M3 metatarsalgia was observed in 21 feet, and 9 feet experienced pain only at M2. The mean follow-up duration was 11 months. All patients had good correction of the HV angle [preoperative median, 36.5 degrees, interquartile range (IQR): 30–45; postoperative median, 10 degrees, IQR: 8.8–10; follow-up median, 11.5 degrees, IQR: 10–14; P < 0.01]. At follow-up, metatarsalgia was resolved in most patients (30 vs 5). There was a clinically negligible decrease in the corrected angles at the final follow-up, and the overall AOFAS score was significantly better (median, 65 points, IQR: 53.8–70; vs 80 points, IQR: 75–85; P < 0.01). CONCLUSION The developed method showed good sustainability of correction power in a small sample of patients at the one-year follow-up. Randomized clinical trials with larger samples, as well as long-term outcome assessments, are needed in the future.

Hallux valgus , Lapidus procedure , Metatarsalgia , Proximal metatarsal osteotomy , Splayfoot , Tailor’s bunion

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Department of Traumatology and Orthopaedics, The National Scientific Center of Traumatology and Orthopaedics Named after Academician Batpenov ND, Astana, 010000, Kazakhstan
Department of Traumatology and Paediatric Surgery, Non-Commercial Joint-Stock Company “Semey Medical University”, Semey, 071400, Kazakhstan
Department of Habilitation and Rehabilitation, Center of Habilitation and Rehabilitation of Persons with Disabilities of the Abai Region, Semey, 071400, Kazakhstan
Department of Anaesthesiology and Resuscitation, Center of Nuclear Medicine and Oncology, Semey, 071400, Kazakhstan

Department of Traumatology and Orthopaedics
Department of Traumatology and Paediatric Surgery
Department of Habilitation and Rehabilitation
Department of Anaesthesiology and Resuscitation

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