Foot and Ankle Surgery Institute Editorial Team

A recent poster at the American Orthopaedic Foot and Ankle Society (AOFAS) Annual Meeting examined minimally invasive surgery (MIS) for hallux valgus in patients with and without diabetes.¹ The cohort consisted of 319 patients (342 MIS procedures) between 2018 and 2023. Of these patients, 45 had diabetes (DM-HV), and 274 did not (NDM-HV). This encompassed 46 and 296 feet, respectively.¹ Each patient underwent a percutaneous Chevron first metatarsal osteotomy for hallux valgus, with a Shannon burr and Kirschner wire fixation, under fluoroscopy. The patients with diabetes were between 51 and 87 years old (mean 73 years) and those without diabetes ranged from 34 to 97 years of age (mean 58).1 The male-to-female ratio in each group was 14:32 (DM-HV) and 49:247 (NDM-HV).¹

The author found that the AOFAS score improved in both groups, including from 41.42 preop to 93.10 postop in the DM-HV group. The NDM-HV group saw improvement from a score of 42.50 to 94.38.¹ The cohort with diabetes exhibited a 4.3% complication rate and those without diabetes had a 4.7% complication rate.1 Complications included hallux varus, K-wire breakage, undercorrection, metatarsalgia, incision dehiscence and adhesion.¹

Overall, no significant difference in AOFAS score, radiographic correction, surgical duration, complications, and reoperations were identifiable between the two groups. The author then contends that MIS Chevron osteotomy with a Shannon burr and K-wire fixation can be a reliable and safe option for hallux valgus correction in patients with diabetes.¹

Reference

Yang DC. Results of hallux valgus surgery in diabetic patients with percutaneous first metatarsal osteotomy and K-wire fixation. e-Poster presented at the American Orthopaedic Foot & Ankle Society Annual Meeting. September 11-14, 2024. Vancouver, Canada.