J Korean Foot Ankle Soc.  2021 Dec;25(4):157-164. 10.14193/jkfas.2021.25.4.157.

Current Trends in the Treatment of Hallux Valgus: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey

• Cho J
• Cho BK
• Park HW
• Sung KS
• Bae SY
• The Academic Committee of Korean Foot and Ankle Society, 2021

• KMID: 2523296
• DOI: http://doi.org/10.14193/jkfas.2021.25.4.157

Abstract

Purpose
This study aimed to report the current trends in the management of the hallux valgus (HV) deformity over the last few decades through a survey of the Korean Foot and Ankle Society (KFAS) members.
Materials and Methods
A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experience in correction in patients with an HV deformity. Answers with a prevalence of ≥50% of respondents were considered a tendency.
Results
One hundred and nine (19.8%) of the 550 members responded to the survey. The most common symptom for determining surgical treatment was bunion pain (68.8%), and different surgical techniques were selected according to the following radiological parameters: HV angle 30 to 40 degrees and intermetatarsal angle 15 to 20 degrees. The two procedures most preferred by the respondents were distal chevron osteotomy (55.0%), and proximal chevron osteotomy (21.1%). In an average of 71.6% of respondents, Arkin osteotomy was performed simultaneously during HV surgery. HV accompanied by an overriding deformity of the second toe was most often addressed with a combination of second metatarsal osteotomy and soft tissue rebalancing procedure (35.8%). After HV surgery, the recurrence rate of HV deformity was found to be 12.2% on average and the surgeons who had performed minimally invasive surgery (MIS) for HV comprised 34.9% of the total respondents.
Conclusion
This study provides updated information on the current trends in the management of the HV deformity in Korea. Both consensus and variation in the approach to patients with HV were identified by this survey study. Although MIS for HV has increased, it appears the consensus for selecting this method has not yet been established.

Keyword

Forefoot; Hallux valgus; Trends; Survey; Korean Foot and Ankle Society

Figure

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  Figure. 1 Number of correction surgeries about hallux valgus in a year.

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  Figure. 2 Degree of significance of the patient- specific factors in decision making for surgical treatment for hallux valgus.

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  Figure. 3 Degree of significance of the radiologic factors in decision making for surgical treatment for hallux valgus. HVA: hallux valgus angle, IMA: first-second intermetatarsal angle, DMAA: distal metatarsal articular angle, TMA: tarso-metatarsal angle, MTPJ: metatarsophalangeal joint, PPAA: proximal phalangeal articular angle.

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  Figure. 4 Degree of hallux valgus angle (HVA) and first-second intermetatarsal angle (IMA) in decision making for severity of hallux valgus or surgical treatment for hallux valgus.

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  Figure. 5 Metatarsal osteotomy, which has been widely used for the past 3 years. (A) Most preferred metatarsal osteotomy. (B) Second preferred metatarsal osteotomy.

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  Figure. 6 Reasons for dissatisfaction after surgical treatment of hallux valgus.

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  Figure. 7 Subjective learning period of hallux valgus correction surgery.

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