J Korean Foot Ankle Soc.  2019 Dec;23(4):149-153. 10.14193/jkfas.2019.23.4.149.

Treatment of Recurrent Hallux Valgus after Surgery

• Kwon KB
• Lee KM

• KMID: 2465937
• DOI: http://doi.org/10.14193/jkfas.2019.23.4.149

Abstract

Recurrence is a common complication following hallux valgus surgery. The postoperative recurrence rates have been reported to be between 2.7% and 16%. Reoperation is considered only for the recurrent deformities with intractable pain. The success of reoperation depends on identifying and addressing the cause of the recurrence appropriately. The surgical principle of reoperation for a recurrent hallux valgus is similar to that of the primary surgery, but arthrodesis and proximal metatarsal osteotomies with greater correcting power are adopted more frequently.

Keyword

Hallux valgus; Bunion; Recurrence; Reoperation; Complication

MeSH Terms

Arthrodesis
Congenital Abnormalities
Hallux Valgus*
Hallux*
Metatarsal Bones
Osteotomy
Pain, Intractable
Recurrence
Reoperation

Figure

• 

  Figure 1 Algorithm for hallux valgus deformity correction. MPT: metatarsophalangeal, TMT: tasometatarsal, DMAA: distal metatarsal articular angle, IMA: intermetatarsal angle.

Reference

1. Nix S, Smith M, Vicenzino B. Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. J Foot Ankle Res. 2010; 3:21. DOI: 10.1186/1757-1146-3-21.

2. Scioli MW. Complications of hallux valgus surgery and subsequent treatment options. Foot Ankle Clin. 1997; 2:719–740.

3. Duan X, Kadakia AR. Salvage of recurrence after failed surgical treatment of hallux valgus. Arch Orthop Trauma Surg. 2012; 132:477–485. DOI: 10.1007/s00402-011-1447-6.

4. Coughlin MJ, Jones CP. Hallux valgus: demographics, etiology, and radiographic assessment. Foot Ankle Int. 2007; 28:759–777. DOI: 10.3113/FAI.2007.0759.

5. Caminear DS, Addis-Thomas E, Brynizcka AW, Saxena A. Revision hallux valgus surgery. In : Saxena A, editor. International advances in foot and ankle surgery. London: Springer;2012. p. 71–82.

6. Kadakia AR, Smerek JP, Myerson MS. Radiographic results after percutaneous distal metatarsal osteotomy for correction of hallux valgus deformity. Foot Ankle Int. 2007; 28:355–360. DOI: 10.3113/FAI.2007.0355.

7. Pentikainen I, Ojala R, Ohtonen P, Piippo J, Leppilahti J. Preoperative radiological factors correlated to long-term recurrence of hallux valgus following distal chevron osteotomy. Foot Ankle Int. 2014; 35:1262–1267. DOI: 10.1177/1071100714548703.

8. Aiyer A, Shub J, Shariff R, Ying L, Myerson M. Radiographic recurrence of deformity after hallux valgus surgery in patients with metatarsus adductus. Foot Ankle Int. 2016; 37:165–171. DOI: 10.1177/1071100715608372.

9. Shibuya N, Kyprios EM, Panchani PN, Martin LR, Thorud JC, Jupiter DC. Factors associated with early loss of hallux valgus correction. J Foot Ankle Surg. 2018; 57:236–240. DOI: 10.1053/j.jfas.2017.08.018.

10. Raikin SM, Miller AG, Daniel J. Recurrence of hallux valgus: a review. Foot Ankle Clin. 2014; 19:259–274. DOI: 10.1016/j.fcl.2014.02.008.

11. Kilmartin TE. Revision of failed foot surgery: a critical analysis. J Foot Ankle Surg. 2002; 41:309–315. DOI: 10.1016/s1067-2516(02)80049-7.

12. Fokter SK, Podobnik J, Vengust V. Late results of modified Mitchell procedure for the treatment of hallux valgus. Foot Ankle Int. 1999; 20:296–300. DOI: 10.1177/107110079902000504.

13. Johnson JE, Clanton TO, Baxter DE, Gottlieb MS. Comparison of Chevron osteotomy and modified McBride bunionectomy for correction of mild to moderate hallux valgus deformity. Foot Ankle. 1991; 12:61–68. DOI: 10.1177/107110079101200201.

14. Iyer S, Demetracopoulos CA, Sofka CM, Ellis SJ. High rate of recurrence following proximal medial opening wedge osteotomy for correction of moderate hallux valgus. Foot Ankle Int. 2015; 36:756–763. DOI: 10.1177/1071100715577195.

15. Okuda R, Kinoshita M, Yasuda T, Jotoku T, Shima H, Takamura M. Hallux valgus angle as a predictor of recurrence following proximal metatarsal osteotomy. J Orthop Sci. 2011; 16:760–764. DOI: 10.1007/s00776-011-0136-1.

16. Coetzee JC, Resig SG, Kuskowski M, Saleh KJ. The Lapidus procedure as salvage after failed surgical treatment of hallux valgus: a prospective cohort study. J Bone Joint Surg Am. 2003; 85:60–65. DOI: 10.2106/00004623-200301000-00010.

17. Osterhoff G, Böni T, Berli M. Recurrence of acute Charcot neuropathic osteoarthropathy after conservative treatment. Foot Ankle Int. 2013; 34:359–364. DOI: 10.1177/1071100712464957.

18. Miller AG, Margules A, Raikin SM. Risk factors for wound complications after ankle fracture surgery. J Bone Joint Surg Am. 2012; 94:2047–2052. DOI: 10.2106/JBJS.K.01088.

19. Sammarco GJ, Idusuyi OB. Complications after surgery of the hallux. Clin Orthop Relat Res. 2001; (391):59–71. DOI: 10.1097/00003086-200110000-00008.

20. Coughlin MJ. Roger A. Mann Award Juvenile hallux valgus: etiology and treatment. Foot Ankle Int. 1995; 16:682–697. DOI: 10.1177/107110079501601104.

21. Okuda R, Kinoshita M, Yasuda T, Jotoku T, Kitano N, Shima H. Postoperative incomplete reduction of the sesamoids as a risk factor for recurrence of hallux valgus. J Bone Joint Surg Am. 2009; 91:1637–1645. DOI: 10.2106/JBJS.H.00796.

22. Park CH, Lee WC. Recurrence of hallux valgus can be predicted from immediate postoperative non-weight-bearing radiographs. J Bone Joint Surg Am. 2017; 99:1190–1197. DOI: 10.2106/JBJS.16.00980.

23. Alvarez R, Haddad RJ, Gould N, Trevino S. The simple bunion: anatomy at the metatarsophalangeal joint of the great toe. Foot Ankle. 1984; 4:229–240. DOI: 10.1177/107110078400400502.

24. Okuda R, Kinoshita M, Yasuda T, Jotoku T, Kitano N, Shima H. The shape of the lateral edge of the first metatarsal head as a risk factor for recurrence of hallux valgus. J Bone Joint Surg Am. 2007; 89:2163–2172. DOI: 10.2106/JBJS.F.01455.

25. Kitaoka HB, Franco MG, Weaver AL, Ilstrup DM. Simple bunionectomy with medial capsulorrhaphy. Foot Ankle. 1991; 12:86–91. DOI: 10.1177/107110079101200205.

26. Belczyk R, Stapleton JJ, Grossman JP, Zgonis T. Complications and revisional hallux valgus surgery. Clin Podiatr Med Surg. 2009; 26:475–484. DOI: 10.1016/j.cpm.2009.04.002.

27. Johnson KA, Cofield RH, Morrey BF. Chevron osteotomy for hallux valgus. Clin Orthop Relat Res. 1979; (142):44–47.

28. Scranton PE Jr, McDermott JE. Prognostic factors in bunion surgery. Foot Ankle Int. 1995; 16:698–704. DOI: 10.1177/107110079501601105.

29. Min BC, Chung CY, Park MS, Choi Y, Koo S, Jang S, et al. Dynamic first tarsometatarsal instability during gait evaluated by pedobarographic examination in patients with hallux valgus. Foot Ankle Int. 2019; 40:1104–1109. DOI: 10.1177/1071100719850802.

30. Cottom JM, Vora AM. Fixation of lapidus arthrodesis with a plantar interfragmentary screw and medial locking plate: a report of 88 cases. J Foot Ankle Surg. 2013; 52:465–469. DOI: 10.1053/j.jfas.2013.02.013.

31. Edwards WH. Avascular necrosis of the first metatarsal head. Foot Ankle Clin. 2005; 10:117–127. DOI: 10.1016/j.fcl.2004.11.001.

32. Coughlin MJ, Mann RA, Salzmann C. Surgery of the foot and ankle. 8th ed. Philadelphia: Mosby;2007.

33. Lagaay PM, Hamilton GA, Ford LA, Williams ME, Rush SM, Schuberth JM. Rates of revision surgery using chevron-austin osteotomy, Lapidus arthrodesis, and closing base wedge osteotomy for correction of hallux valgus deformity. J Foot Ankle Surg. 2008; 47:267–272. DOI: 10.1053/j.jfas.2008.03.002.

34. Kitaoka HB, Patzer GL. Arthrodesis versus resection arthroplasty for failed hallux valgus operations. Clin Orthop Relat Res. 1998; (347):208–214. DOI: 10.1097/00003086-199802000-00025.

35. Vienne P, Sukthankar A, Favre P, Werner CM, Baumer A, Zingg PO. Metatarsophalangeal joint arthrodesis after failed Keller-Brandes procedure. Foot Ankle Int. 2006; 27:894–901. DOI: 10.1177/107110070602701105.

36. Bock P, Lanz U, Kröner A, Grabmeier G, Engel A. The Scarf osteotomy: a salvage procedure for recurrent hallux valgus in selected cases. Clin Orthop Relat Res. 2010; 468:2177–2187. DOI: 10.1007/s11999-010-1363-z.

37. Baravarian B, Ben-Ad R. Revision hallux valgus: causes and correction options. Clin Podiatr Med Surg. 2014; 31:291–298. DOI: 10.1016/j.cpm.2013.12.010.