Percutaneous Osteotomies in Hallux Valgus: A Systematic Review

A. Bia, F. Guerra-Pinto, B.S. Pereira, N. Corte-Real, X.M. Oliva

Research output: Contribution to journalReview articlepeer-review

47 Citations (Scopus)


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
Original languageEnglish
Pages (from-to)123-130
Number of pages8
JournalJournal of Foot and Ankle Surgery
Issue number1
Publication statusPublished - Jan 2018


  • hallux valgus
  • minimally invasive
  • osteotomy
  • percutaneous
  • Reverdin-Isham
  • American Orthopaedic Foot and Ankle Society Ankle Hindfoot scale score
  • Bosch osteotomy
  • case control study
  • case study
  • complex regional pain syndrome
  • dermatitis
  • follow up
  • human
  • joint stiffness
  • Magnan osteotomy
  • Manchester Oxford Foot Questionnaire
  • meta analysis
  • minimally invasive surgery
  • percutaneous chevron osteotomy
  • percutaneous double osteotomy
  • phalanx fracture
  • postoperative infection
  • postoperative period
  • prospective study
  • questionnaire
  • recurrent disease
  • retrospective study
  • Reverdin Isham osteotomy
  • Review
  • risk factor
  • scoring system
  • systematic review
  • treatment outcome
  • United States
  • validation study


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