J Child Orthop. 2015 Apr;9(2):105-12. doi: 10.1007/s11832-015-0655-y. Epub 2015 Apr 22.
Adolescent hallux valgus: a systematic review of outcomes following surgery.
Journal of children's orthopaedics
Ziad Harb, Michail Kokkinakis, Hiba Ismail, Gavin Spence
Affiliations
Affiliations
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK, [email protected].
PMID: 25899450
PMCID: PMC4417735 DOI: 10.1007/s11832-015-0655-y
Abstract
PURPOSE: The management of adolescent hallux valgus (AHV) remains controversial, with reservations about both conservative and surgical treatments. Non-operative management has a limited role in preventing progression. Surgical correction of AHV has, amongst other concerns, been associated with a high prevalence of recurrence of deformity after surgery. We conducted a systematic review to assess clinical and radiological outcomes following surgery for AHV.
METHODS: A comprehensive literature search was performed in the Cochrane Library, CINAHL, EMBASE, Google Scholar and PubMed. The study was performed in accordance with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Demographic data, radiographic parameters and results of validated clinical scoring systems were analysed.
RESULTS: The published literature on AHV is largely heterogeneous and retrospective. Nine contemporary studies reporting on 140 patients (201 osteotomies) were included. The female to male ratio was 10:1. The mean age at operation was 14.5 years (range 10.5-22). The mean follow-up was 41.6 months (range 12-134). The mean post-operative American Orthopaedic Foot and Ankle Society (AOFAS) score was 85.8 (standard deviation, SD ±7.38). The mean AOFAS patient satisfaction showed that 86 % (SD ±11.27) of patients were satisfied or very satisfied with their outcome. On the duPont Bunion Rating Score (BRS), 90 % rated their outcome as good or excellent. There was a statistically significant improvement in the inter-metatarsal angle (IMA, p = 0.0003), hallux valgus angle (HVA, p < 0.0001) and distal metatarsal articular angle (DMAA, p = 0.019).
CONCLUSION: Based on the most current published evidence, contemporary surgical interventions for AHV show excellent clinical and radiological outcomes, with high patient satisfaction. The rates of recurrence and other complications are lower than the historically reported figures. There is a need for high-level, multi-centre collaborative studies with prospective data to establish the long-term outcomes and optimal surgical procedure(s).
References
- J Bone Joint Surg Am. 1992 Oct;74(9):1367-74 - PubMed
- J Foot Ankle Surg. 2002 Jan-Feb;41(1):2-5 - PubMed
- J Pediatr Orthop. 1984 Jan;4(1):39-43 - PubMed
- J Pediatr Orthop. 1990 Sep-Oct;10 (5):642-8 - PubMed
- BMJ. 2009 Jul 21;339:b2535 - PubMed
- J Child Orthop. 2012 Jun;6(2):153-7 - PubMed
- J Child Orthop. 2009 Jun;3(3):185-90 - PubMed
- J Pediatr Orthop. 2007 Oct-Nov;27(7):826-30 - PubMed
- J Orthop Sci. 2005 Sep;10(5):457-65 - PubMed
- Acta Orthop Belg. 2008 Aug;74(4):496-502 - PubMed
- J Pediatr Orthop. 2004 Jul-Aug;24(4):358-62 - PubMed
- Orthop Traumatol Surg Res. 2013 Jun;99(4):433-9 - PubMed
- J Bone Joint Surg Br. 1994 Mar;76(2):210-4 - PubMed
- Orthop Clin North Am. 1974 Jan;5(1):59-66 - PubMed
- Acta Orthop Belg. 2013 Oct;79(5):552-8 - PubMed
- Orthopedics. 1985 Oct;8(10 ):1249-52 - PubMed
- Foot Ankle Int. 2000 Jul;21(7):584-7 - PubMed
- Foot Ankle Int. 1994 Jul;15(7):349-53 - PubMed
- J Orthop Sci. 2013 May;18(3):419-25 - PubMed
- J Bone Joint Surg Br. 2005 Aug;87(8):1038-45 - PubMed
- Clin Orthop Relat Res. 2000 Dec;(381):256-65 - PubMed
- Foot Ankle Spec. 2010 Feb;3(1):10-4 - PubMed
- J Pediatr Orthop. 2002 May-Jun;22(3):375-9 - PubMed
Publication Types