Analysis of different osteotomies used in hallux valgus: A systematic review

Background: A variety of metatarsal (MT) osteotomies have been described for the treatment of hallux valgus (HV) deformity. Many of these techniques were abandoned throughout the years. Because no one procedure has shown to be capable of correcting all types of HV deformities, clinicians have adopted treatment algorithms. Objective: This work aims to review different methods of, as well as indications and contraindications for osteotomies to treat HV in the literature, and provide cumulative data about the intermediate to long-term management of HV. Patients and Methods: An online search was performed using the Medline database on PubMed, Google Scholar, and Science Direct from 2000 to 2019. All English language published studies describing osteotomies in HV were identified and analyzed. Results: Twenty-eight studies were identified from 2000 to 2019. Seventeen of the studies (60.7%) were prospective, whereas 5 studies (17.9%) were retrospective. The most common procedure used were Chevron (10 studies), followed by Reverdin (4 studies), Bosch (4 studies), Magnan (3 studies), Akin (2 studies), and Scarf osteotomy (2 studies). Simple, effective, rapid, inexpensive (SERI), distal linear MT osteotomy, reverse L-shape osteotomy, subcapital osteotomy combined with lateral soft-tissue release, and modified Mitchel were represented by 1 study each. Conclusion: The management of HV involves several procedures. The choice of each patient's procedure depends on the degree and reducibility of deformity, the digital formula used, presence or absence of symptoms from lateral rays. It also depends on the training of the surgeon and the learning curve in his career. Interest in percutaneous surgery has been increasing for both patients and surgeons. The most commonly used procedures were Chevron in 10 studies. Complications occurred in 82.1% of studies, and only 5 (17.9%) had no complications. These studies used SERI, Chevron, Reverdin in one study and Akin in two studies. Chevron was the most commonly used procedure with less complications.