Triple osteotomy of first ray for severe hallux valgus surgery: Long-term follow-up

Abstract

Objective: This study aimed to present a retrospective case series of the long-term results of severe hallux valgus treated with triple osteotomy of the first ray. Methods: Patients with severe hallux valgus treated with a basal medial opening wedge, distal chevron, and Akin osteotomy from 2008 to 2012 were identified from the electronic medical records. Radiological outcomes such as pre- and postoperative hallux valgus angle, intermetatarsal angle, and distal metatarsal articular angle) were collected. Patients were contacted to complete foot and ankle outcome score (FAOS). Results: Nineteen patients underwent 20 triple osteotomies of the first ray. Clinical data and FAOS were collected at a median follow-up of 10.2 years. There was a significant improvement in hallux valgus angle, intermetatarsal angle, and distal metatarsal articular angle from pre- to postoperatively, both at initial and final radiographic follow-up (P < .0001). Patient satisfaction was high, with median FAOS of 94.5 (symptoms), 97 (function/activities of daily living), 100 (function/sport and recreation), 85 (foot and ankle-related quality of life), and 100 (pain). Conclusion: Triple first-ray osteotomy is a successful mode of treatment for severe hallux valgus, with high levels of patient satisfaction and excellent improvement in radiological parameters measured over long-term follow-up.