Surgical treatment of Hallux extensus

Abstract

Introduction

This study is a comparative assessment of early and long-term results of two different methods of surgical treatment of hallux extensus.

Materials and methods

The results of surgical treatment of 22 patients with Hallux extensus at the orthopedic department of the Moscow Yudin City Hospital from 2017 to 2019 were studied. The patients were divided into 2 groups depending on the tactics of surgical treatment. The main goal of this study is a comparative assessment of the functional results of two surgical techniques. The first group of patients, which included 11 subjects, underwent needle percutaneous tenotomy of the extensor tendon of the big toe, the second group, which also consisted of 11 people, underwent tenodesis of the tendon-muscular part of the short flexor of the big toe according to the proposed by us technique.

Results

The study results are based on the assessment of subjective patient satisfaction and radiography images, as well as on the ACFAS score. In the group of patients who underwent percutaneous tenotomy of the extensor tendon of the big toe, there was a recurrence of deformity in 4 patients (36 %) and insufficient correction of the deformity in 2 patients (18 %). In the group of patients who underwent tenodesis of the tendon-muscle part of the short flexor of the big toe, 100 % showed good functional results, pain relief and esthetic effect. Good treatment results were observed in 73.3 % of the patients.

Conclusions

Analysis of the clinical results of surgical treatment showed a high efficacy of tenodesis of the tendon-muscle part of the short flexor of the big toe in comparison with percutaneous tenotomy of the extensor tendon of the big toe. Positive results were achieved in 100 % of cases. No recurrence of deformity was observed. The patients did not complain of pain, and there were no problems with footwear in the postoperative period.