TY - JOUR
T1 - Percutaneous Osteotomies in Hallux Valgus: A Systematic Review
AU - Bia, A.
AU - Guerra-Pinto, F.
AU - Pereira, B.S.
AU - Corte-Real, N.
AU - Oliva, X.M.
N1 - Export Date: 24 January 2018
CODEN: JFSUE
Correspondence Address: Bia, A.; Department of Orthopedic Surgery, Centro Hospitalar do Oeste-Unidade de Torres, Rua Dr. Ricardo Belo, Portugal; email: anagbia@gmail.com
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PY - 2018/1
Y1 - 2018/1
N2 - Percutaneous and minimally invasive surgery is one of the greatest advances in the operating field of orthopedic since the late 1990s. The potential advantages include a shorter operative time, quicker recovery, and reduced hospital stay compared with traditional open surgery. However, scientific validation of the safety and efficacy of hallux valgus (HV) percutaneous surgery remains inconclusive. The objective of the present study was to systematically review the published data and clinical evidence for percutaneous HV surgery, evaluate the scientific method of the reports, and clarify the indications, safety, efficacy, and potential risks of these surgical techniques. Two reviewers independently identified the studies using a PubMed search, with the keywords “hallux valgus,” “osteotomy,” “minimally invasive,” and “percutaneous.” Quality assessment was performed using the Coleman methodology scale, and each study was assigned a level of evidence and grade of recommendation. Eighteen studies were included and reported a total of 1534 procedures for percutaneous HV surgery on 1397 patients. Of the 18 studies, 14 (77.8%) were level IV, 2 (11.1%) were level III, and 2 (11.1%) were level II. Overall, the average angle correction of the HV deformity improved postoperatively. Regarding the complications, although some investigators revealed no major complications, others described deformity recurrence in 7.8%, stiffness of the first metatarsophalangeal joint in 9.8%, malunion in 4% to 8.7%, and infection rates ranging from 1.9% to 14.3%. The main indication for percutaneous HV surgery is the correction of mild deformities. The complication rate was elevated even in experienced surgeons. In conclusion, future research in percutaneous techniques should include adequately sized randomized control trials, standardization of treatment protocols, and the use of validated tools for the measurement of clinical outcomes. © 2017 American College of Foot and Ankle Surgeons
AB - Percutaneous and minimally invasive surgery is one of the greatest advances in the operating field of orthopedic since the late 1990s. The potential advantages include a shorter operative time, quicker recovery, and reduced hospital stay compared with traditional open surgery. However, scientific validation of the safety and efficacy of hallux valgus (HV) percutaneous surgery remains inconclusive. The objective of the present study was to systematically review the published data and clinical evidence for percutaneous HV surgery, evaluate the scientific method of the reports, and clarify the indications, safety, efficacy, and potential risks of these surgical techniques. Two reviewers independently identified the studies using a PubMed search, with the keywords “hallux valgus,” “osteotomy,” “minimally invasive,” and “percutaneous.” Quality assessment was performed using the Coleman methodology scale, and each study was assigned a level of evidence and grade of recommendation. Eighteen studies were included and reported a total of 1534 procedures for percutaneous HV surgery on 1397 patients. Of the 18 studies, 14 (77.8%) were level IV, 2 (11.1%) were level III, and 2 (11.1%) were level II. Overall, the average angle correction of the HV deformity improved postoperatively. Regarding the complications, although some investigators revealed no major complications, others described deformity recurrence in 7.8%, stiffness of the first metatarsophalangeal joint in 9.8%, malunion in 4% to 8.7%, and infection rates ranging from 1.9% to 14.3%. The main indication for percutaneous HV surgery is the correction of mild deformities. The complication rate was elevated even in experienced surgeons. In conclusion, future research in percutaneous techniques should include adequately sized randomized control trials, standardization of treatment protocols, and the use of validated tools for the measurement of clinical outcomes. © 2017 American College of Foot and Ankle Surgeons
KW - hallux valgus
KW - minimally invasive
KW - osteotomy
KW - percutaneous
KW - Reverdin-Isham
KW - American Orthopaedic Foot and Ankle Society Ankle Hindfoot scale score
KW - Bosch osteotomy
KW - case control study
KW - case study
KW - complex regional pain syndrome
KW - dermatitis
KW - follow up
KW - human
KW - joint stiffness
KW - Magnan osteotomy
KW - Manchester Oxford Foot Questionnaire
KW - meta analysis
KW - minimally invasive surgery
KW - percutaneous chevron osteotomy
KW - percutaneous double osteotomy
KW - phalanx fracture
KW - postoperative infection
KW - postoperative period
KW - prospective study
KW - questionnaire
KW - recurrent disease
KW - retrospective study
KW - Reverdin Isham osteotomy
KW - Review
KW - risk factor
KW - scoring system
KW - systematic review
KW - treatment outcome
KW - United States
KW - validation study
U2 - 10.1053/j.jfas.2017.06.027
DO - 10.1053/j.jfas.2017.06.027
M3 - Review article
C2 - 28870735
VL - 57
SP - 123
EP - 130
JO - Journal of Foot and Ankle Surgery
JF - Journal of Foot and Ankle Surgery
SN - 1067-2516
IS - 1
ER -