Hallux valgus: choosing the appropriate surgical technique
Keywords:
Hallux Valgus; minimally invasive surgery; PECA; MICA; META; PETA; metatarsus adductus; scarf osteotomy; metatarsal pronationAbstract
The frequency of Hallux Valgus deformity in the general population is quite high, thus many orthopaedic surgeons, not only foot and ankle specialists, perform forefoot reconstructive surgery in their daily practice. Highly sophisticated techniques require deep knowledge, experience and completion of the learning curve in order to avoid some of the poorer outcomes documented within the literature. Distal, diaphyseal, metadiaphyseal and proximal types of osteotomies have been described according to the extent of the deformity. Fusion techniques have been modified to offer more predictable results. Frontal derotational osteotomies have been devised to address the metatarsal pronation element of Hallux Valgus pathology. Percutaneous techniques have evolved and are considered a safe solution to a certain and strictly defined spectrum of indications. A table of scenarios on Hallux Valgus deformities and their corresponding surgical treatment is proposed for decision-making. The osteotomy type choice is considered multifactorial and is certainly based on surgeons’ experience, training and knowledge of the exact pathology of the deformity.
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