TY - JOUR
T1 - Role of a limited transarticular release in severe hallux valgus correction
AU - Wagner, Emilio
AU - Ortiz, Cristian
AU - Figueroa, Francisco
AU - Vela, Omar
AU - Wagner, Pablo
AU - Gould, John S.
N1 - Publisher Copyright:
© 2015 American Orthopaedic Foot & Ankle Society.
PY - 2015/11/1
Y1 - 2015/11/1
N2 - Background: Hallux valgus (HV) treatment is continuously evolving, and no definitive treatment can be recommended. Osteotomies are the main surgical choice for these deformities, but no clear role for soft tissue procedures is available. Objective: To perform a retrospective comparison of the radiographic and clinical outcomes of 2 groups of patients with severe HV operated with the same osteotomy technique but differing on the type of lateral release. Methods: Two groups of patients with symptomatic moderate to severe HV deformities were operated with the same proximal metatarsal osteotomy, which differed on the type of lateral release: group 1 had limited transarticular lateral capsule release (n = 62), and group 2 complete lateral release, including capsule, adductor tendon, and intermetatarsal (IM) ligament (n = 57). We recorded the American Orthopaedic Foot & Ankle Society (AOFAS) score, HV and IM angles, first metatarsal shortening, concomitant metatarsal shortening osteotomies (Weil), Akin osteotomies, and complications. Results: The postoperative AOFAS score in group 1 was similar to that of group 2. The HV and IM angles improved in both groups with no significant difference. The multivariate analysis showed no influence of any variable analyzed on HV or IM angle improvement. Regarding AOFAS score improvement, a limited lateral release was associated with a higher increase in AOFAS score (P =.019). Conclusion: No studies are available to identify which soft tissue structures are involved in HV deformities nor which have to be released, if any. A limited transarticular release can provide similar clinical and radiologic outcomes when compared with a classic open lateral release. Level of Evidence: Level IV, case series.
AB - Background: Hallux valgus (HV) treatment is continuously evolving, and no definitive treatment can be recommended. Osteotomies are the main surgical choice for these deformities, but no clear role for soft tissue procedures is available. Objective: To perform a retrospective comparison of the radiographic and clinical outcomes of 2 groups of patients with severe HV operated with the same osteotomy technique but differing on the type of lateral release. Methods: Two groups of patients with symptomatic moderate to severe HV deformities were operated with the same proximal metatarsal osteotomy, which differed on the type of lateral release: group 1 had limited transarticular lateral capsule release (n = 62), and group 2 complete lateral release, including capsule, adductor tendon, and intermetatarsal (IM) ligament (n = 57). We recorded the American Orthopaedic Foot & Ankle Society (AOFAS) score, HV and IM angles, first metatarsal shortening, concomitant metatarsal shortening osteotomies (Weil), Akin osteotomies, and complications. Results: The postoperative AOFAS score in group 1 was similar to that of group 2. The HV and IM angles improved in both groups with no significant difference. The multivariate analysis showed no influence of any variable analyzed on HV or IM angle improvement. Regarding AOFAS score improvement, a limited lateral release was associated with a higher increase in AOFAS score (P =.019). Conclusion: No studies are available to identify which soft tissue structures are involved in HV deformities nor which have to be released, if any. A limited transarticular release can provide similar clinical and radiologic outcomes when compared with a classic open lateral release. Level of Evidence: Level IV, case series.
KW - American Orthopaedic Foot & Ankle Society score
KW - complete lateral release
KW - hallux valgus
KW - intermetatarsal angle
KW - limited transarticular release
UR - http://www.scopus.com/inward/record.url?scp=84946019698&partnerID=8YFLogxK
U2 - 10.1177/1071100715593082
DO - 10.1177/1071100715593082
M3 - Article
C2 - 26152873
AN - SCOPUS:84946019698
SN - 1071-1007
VL - 36
SP - 1322
EP - 1329
JO - Foot and Ankle International
JF - Foot and Ankle International
IS - 11
ER -