Percutaneous hallux valgus surgical correction

PICHON-RIVIERE A,; AUGUSTOVSKI, F; ALCARAZ A; BARDACH, ARIEL; FERRANTE, D; GARCIA MARTÍ, SEBASTIAN; GLUJOVSKY, D; LOPEZ, A; REGUEIRO, A

Documentos de Evaluación de Tecnologías Sanitarias

IECS

Año: 2007 p. 1 - 30

1668-2793

The objective of the report was to assess the usefulness of percutaneous hallux valgus surgery.A bibliographic search was carried out on the main databases (MEDLINE, EMBASE, Cochrane, DARE, NHS EED), on general Internet engines, in health technology evaluation agencies and health sponsors. Priority was given to the inclusion of systematic reviews; controlled, randomized clinical trials (RCTs); assessment of sanitary technologies and economic evaluations; clinical practice guidelines and coverage policies of other health systems.Only four case series reports of poor methodological quality were found, with subjectively reported results. Magnan et al performed a percutaneous distal metatarsal osteotomy in 118 feet (82 patients) from 1996 to 2001, with a mean clinical and radiological follow-up of 35.9 months. Ninety one percent of patients expressed their satisfaction after surgery. According to the American Orthopedics of the Foot and Ankle Society (AOFA) s hallux metatarsophalangeal-interphalangeal scale, mean score was 88.2  12.9. In the before-after analysis, significant changes (p<0.05) in the radiological evaluation of the hallux valgus, first intermetatarsal angle and sesamoid position were observed. In three cases (2.5%) recurrence in the deformation was observed; in eight cases (6.8%) painless rigidity in the metatarsophalangeal joint was observed and one case (0.8%) presented deep infection which was treated with antibiotic therapy. Portulari et al reported 197 operated feet (in 156 patients). Median follow-up was 16.4 months with clinical and radiological results showing positive results in 89% of the cases. Sanna et al report this surgery in 90 feet (83 patients). They present clinical and radiological results similar to those obtained with conventional surgery with less complications and better acceptance in patients.