Efficacy of Bilateral Simultaneous Hallux Valgus Correction Compared to Unilateral

Abstract

Background: Hallux valgus affects up to 29% of adults and can be bilateral in 84% of cases. Contemporary surgical techniques provide the possibility of simultaneous bilateral correction, but still there is no consensus on whether staged or simultaneous correction should be performed if both feet are involved. The aim of the present study was to report our experience of treatment of patients with hallux valgus and to perform comparative analysis of results obtained from unilateral and simultaneous bilateral surgical correction. Methods: Data on 60 feet (40 patients) with hallux valgus that underwent surgery between 2010 and 2013 using scarf osteotomy and lateral soft tissue release were analyzed. Unilateral correction was performed in 30 feet (25 patients) and bilateral correction in 30 feet (15 patients). The patients from both groups were admitted to hospital for 7 days. Functional assessment (American Orthopaedic Foot & Ankle Society [AOFAS] score) and radiographic examination (intermetatarsal and hallux valgus angles) were performed preoperatively and at 6, 12, and 24 months after the procedure. Comparative analysis between groups with bilateral and unilateral correction was carried out. Results: At 24 months after surgery in the bilateral and unilateral groups, the mean AOFAS score was 86 ± 6.2 and 86 ± 6.9 ( P > .05), the mean intermetatarsal angle was 8.4 ± 0.5 and 8.8 ± 0.8 degrees ( P > .05), and the mean metatarsophalangeal angle was 13.0 ± 1.2 and 13.0 ± 0.9 degrees ( P > .05), respectively. Conclusion: According to the data obtained, simultaneous bilateral correction had the same functional and radiographic results as unilateral surgery. Level of Evidence: Level III, case series.