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Recurrence of Hallux Valgus Can Be Predicted from Immediate Postoperative Non-Weight-Bearing Radiographs

Park, Chul Hyun MD, PhD1,a; Lee, Woo-Chun MD, PhD2,b

Journal of Bone & Joint Surgery - American Volume: 19 July 2017 - Volume 99 - Issue 14 - p 1190–1197
doi: 10.2106/JBJS.16.00980
Scientific Articles
Disclosures
Commentary

Background: The aims of this study were to identify risk factors for the recurrence of hallux valgus deformity and to clarify whether recurrence after surgery to treat hallux valgus can be predicted using radiographic parameters assessed on immediate postoperative non-weight-bearing radiographs.

Methods: A proximal chevron osteotomy combined with a distal soft-tissue procedure was performed by a single surgeon to treat moderate to severe hallux valgus deformity in 93 patients (117 feet). The feet were grouped according to nonrecurrence or recurrence. Changes in the hallux valgus angle, the intermetatarsal angle, and sesamoid position over time were analyzed by comparing values measured during each postoperative period. The relative risks of recurrence as indicated by preoperative and postoperative radiographic parameters were determined.

Results: Twenty (17.1%) of the 117 feet showed hallux valgus recurrence at the time of the last follow-up. The hallux valgus angle and the intermetatarsal angle stabilized at 6 months after surgery in the nonrecurrence group. An immediate postoperative hallux valgus angle of ≥8°, an immediate postoperative sesamoid position of grade 4 or greater, a preoperative metatarsus adductus angle of ≥23°, and a preoperative hallux valgus angle of ≥40° were significantly associated with recurrence.

Conclusions: Recurrence of hallux valgus after a proximal chevron osteotomy can be reliably predicted from immediate postoperative non-weight-bearing radiographs.

Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

1Department of Orthopedic Surgery, Yeungnam University Medical Center, Daegu, Republic of Korea

2Seoul Foot and Ankle Center, Inje University Seoul Paik Hospital, Seoul, Republic of Korea

E-mail address for C.H. Park: chpark77@naver.com

E-mail address for W.-C. Lee: leewoochun@gmail.com

Copyright 2017 by The Journal of Bone and Joint Surgery, Incorporated
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