Minimal Invasive Hallux Valgus Surgery: Myth or Magic. A Systematic Review

A Better understanding of foot biomechanics coupled with technological advancement and governance to improve patient outcomes have facilitated newer innovations in Hallux Valgus (HV) surgery. Minimally Invasive Surgery (MIS) is one of the greatest advances in modern medicine and an emerging trend in foot and ankle surgeries. The needs to provide a quicker post- operative recovery, reduce operative time and minimize complications have led to development of various MIS techniques in HV correction over the past decades. This systematic review aims to establish the efficacy and safety of MIS for HV correction. A systematic search of Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Medline, Science Direct and Cochrane Central Registry of Controlled Trials from inception of database till 28 th February 2014 was conducted. A total of 27 English language articles published in peer reviewed journals with available clinical and radiological outcome measures were deemed appropriate and were critically analyzed to determine the efficacy and safety of minimally invasive HV surgery (MIHVS). These studies included a total of 1485 patients with 1952 surgical procedures using MIHVS. The clinical and radiological outcomes achieved with MIHVS along the complications reported were comparable with the conventional open techniques. The MIHVS within this review consisted of case series that differed in terms of procedure, patient selection, techniques, instrumentation, rehabilitation protocol, use of fluoroscopy and reporting outcome measures. The complication rates were significantly lower in centers specializing with MIHVS. Higher levels of evidence with large population studies are required to recommend MIHVS which have shorter operating time, quicker recovery and reduced hospital stay compare to open surgery.