Hallux Valgus Recurrence After Simple Bunionectomy: Algorithm Treatment

Abstract

Background: Recurrences of hallux valgus can be difficult to manage, especially after a prior simple bunionectomy. This study aimed to present a treatment algorithm for the correction of recurrences after a simple bunionectomy.Methods: This was a single-center, descriptive, and retrospective comparative study. Thirty-four consecutive patients were classified according to the bone stock and the presence or absence of end-stage arthritis of the first metatarsophalangeal joint (MTPJ). According to our algorithm, we only performed an osteotomy as the salvage procedure in cases with sufficient bone stock and absence of or mild arthritis. In the other cases, we performed an MTPJ fusion. Exceptionally, we chose a Keller-Brandes arthroplasty for patients with advanced age and comorbidities. Results: We performed 17 scarf osteotomies (50%), 15 MTPJ arthrodeses (44.1%), and 2 Keller-Brandes arthroplasties (5.9%). Following the algorithm, we achieved an improvement of the AOFAS score of >30 points without severe complications in all groups.Conclusions: The proposed operative algorithm successfully addresses the recurrences considering the lack of bone stock and the presence of MTPJ arthritis.Level of EvidenceLevel 3: retrospective comparative study