Efficacy of minimally PCWO combined with Akin osteotomy on severe hallux valgus

Guodong SHEN; Yunxuan ZHOU; Hongning ZHANG; Xue LI; Kangyong YANG; Zhibin LAI; Yongzhan ZHU

ABSTRACT

Objective:

To study the efficacy of minimally PCWO combined with Akin osteotomy on severe hallux valgus.

Methods:

This retrospective study was conducted on 45 patients (50 feet) with severe hallux valgus treated by minimally PCWO combined with Akin osteotomy in Eight Department of Bone, Foshan Hospital of traditional Chinese Medicine from August 2016 to August 2018. HVA, IMA, DMAA, DASA, IPA were measured by X-ray examination preoperatively and after operative 3, 6, 12 months and at the final follow-up. The efficacy was evaluated in accordance with the American Orthopaedic Foot and Ankle Association (AOFAS) Ankle Hindfoot Scale and the Olerud-Molander Ankle (OMA) Score. The absolute and relative lengths of the first metatarsus were measured by X-ray examination preoperatively and at the last follow-up, with calculating the differences.

Result:

All patients were followed up within 18.20±2.04 months. There was no recurrence during follow-up period. HVA was 42.83°±4.63°, 12.83°±1.53°, 13.49°±1.33°, 14.08°±1.49° and 14.12°±1.35° at the preoperative, postoperative 3 months, 6 months, 12 months and the last follow-up, respectively, and the difference between pre-operation and post-operation was statistically significant ( P<0.05). IMA was 18.29°±0.94°, 7.84°±1.22°, 8.31°±1.03°, 9.01°±1.08° and 9.09°±1.11° at the preoperative, postoperative 3 months, 6 months, 12 months and the last follow-up, respectively, and the difference between pre-operation and post-operation was statistically significant ( P<0.05). AOFAS scores were 50.64±7.94, 88.80±2.68, 90.10±3.51, 91.20±3.89 and 91.37±3.71 points at the preoperative, postoperative 3 months, 6 months, 12 months and the last follow-up, respectively, and the difference between pre-operation and post-operation was statistically significant ( P<0.05). The OMA scores were 61.00±7.00, 90.90±5.02, 91.60±4.57, 93.20±3.61 and 93.48±4.91 at preoperative, postoperative 3 months, 6 months, 12 months and the last follow-up, respectively, and the difference between pre-operation and post-operation was statistically significant ( P<0.05). The absolute shortening of the first metatarsal was 3.03 mm and relative shortening was 0.72 mm.

Conclusion:

For severe hallux valgus, minimally PCWO combined with Akin osteotomy can effectively correct the hallux valgus deformity with small surgical incision, high safety and curative effect, which is worthy of popularization and application in clinical.