Abstract
Complications following bunion correction are not uncommon and are a topic of lively discussion and debate in foot and ankle forums. Complications are a source of frustration for both patients and surgeons, and they compound the morbidity of correction when repeat operations are necessary. Additionally, subsequent treatment and repeat procedures increase the overall cost of bunion surgery which affects the patient, the surgeon, and the healthcare system. All surgical procedures have potential for issues and complications such as infection and soft tissue or bone healing problems and a host of other local and/or systemic problems. Recurrence and hallux varus are the most commonly encountered complications specific to hallux abducto valgus surgery, and these issues will be discussed in this chapter through a thorough literature review and analysis of current norms and emerging trends. Only through understanding the root cause of our failures can we determine the best course of action for improvement.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Agrawal Y, Bajaj SK, Flowers MJ. Scarf-Akin osteotomy for hallux valgus in juvenile and adolescent patients. J Pediatr Orthop. 2015;24(6):535–40.
Aiyer A, Shub J, Shariff R, et al. Radiographic recurrence of deformity after hallux valgus surgery in patients with metatarsus adductus. Foot Ankle Int. 2016;37(2):165–71.
Aiyer A, Shariff R, et al. Prevalence of metatarsus adductus in patients undergoing hallux valgus surgery. Foot Ankle Int. 2014;35(12):1292–7.
Akhtar S, Malek S, Hariharan K. Hallux varus following scarf osteotomy. Foot (Edinb). 2016;29:1–5.
Akpinar E, Buyuk AF, Cetinkaya E, et al. Proximal intermetatarsal divergence in distal chevron osteotomy for hallux valgus: an overlooked finding. J Foot Ankle Surg. 2016;55(3):504–8.
Belczyk R, Stapleton JJ, Grossman JP, et al. Complications and revisional hallux valgus surgery. Clin Podiatr Med Surg. 2009;26:475–84.
Bevernage BD, Leemrijse T. Hallux varus: classification and treatment. Foot Ankle Clin. 2009;14:51–65.
Bock P, Kluger R, Kristen K, et al. The scarf osteotomy with minimally invasive lateral release for treatment of hallux valgus deformity: intermediate and long-term results. J Bone Joint Surg Am Ed. 2015;97(15):1238–45.
Buciuto R. Prospective randomized study of Chron osteotomy versus Mitchell’s osteotomy in hallux valgus. Foot Ankle Int. 2014;34(12):1268–76.
Chen JY, Ang BFH, Jiang L, et al. Pain resolution after hallux valgus surgery. Foot Ankle Int. 2016. doi:10.1177/1071100716653084.
Chen JY, Rikhraj K, Gatot C, et al. Tibial sesamoid position influence on functional outcome and satisfaction after hallux valgus surgery. Foot Ankle Int. 2016. doi:10.1177/1071100716658456.
Choi GW, Choi WJ, Yoon HS, et al. Additional surgical factors affecting the recurrence of hallux valgus after Ludloff osteotomy. Bone Joint J. 2013;95-B(6):803–8.
Choi JH, Zide JR, Coleman SC, et al. Prospective study of the treatment of adult primary hallux valgus with scarf osteotomy and soft tissue realignment. Foot Ankle Int. 2013;34(5):684–90.
Choi KJ, Lee HS, Yoon YS, et al. Distal metatarsal osteotomy for hallux varus following surgery for hallux valgus. J Bone Joint Surg (Br). 2011;93(8):1079–83.
Chopra S, Moerenhout K, Crevoisier X. Subjective versus objective assesment in early clinical outcome of modified lapidus procedure for hallux valgus deformity. Clin Biomech. 2016;32:187–93.
Chong A, Nazarian N, Chandrananth J, et al. Surgery for the correction of hallux valgus: minimum five-year results with a validated patient-reported outcome tool and regression analysis. Bone Joint J. 2015;97-B(2):208–14.
Coetzee JC. Scarf osteotomy for hallux valgus repair: the dark side. Foot Ankle Int. 2003;24(1):29.
Coughlin MJ, Mann RA. Surgery of the foot and ankle. 7th ed. St Louis: Mosby; 1999. p. 258–66.
Coughlin MJ, Jones CP. Hallux valgus and first ray mobility. A prospective study. J Bone Joint Surg Am Ed. 2007;89(9):1887–98.
Coughlin MJ, Saltzman CL, Nunley JA. Angular measurements in the evaluation of hallux valgus deformities: a report of the ad hoc committee of the American Orthopaedic Foot & Ankle Society on angular measurements. Foot Ankle Int. 2002;23(1):68.
Crawford MD, Patel J, Giza E. Iatrogenic hallux varus treatment algorithm. Foot Ankle Clin N Am. 2014;19:371–84.
Deenik AR, De Visser E, Louwerens JW, et al. Hallux valgus angle as main predictor for correction of hallux valgus. BMC Musculoskelet Disord. 2008;9:70.
Deveci A, Firat A, Yilmaz S, et al. Short-term clinical and radiologic results of the scarf osteotomy: what factors contribute to recurrence? J Foot Ankle Surg. 2013;52:771–5.
Diebold PF, Delagoutte JP. A propos du Traitement de L’Hallux varus Post-opératoire. Méd Chir Pied. 1988;4:41–3.
Edelman RD. Iatrogenically induced hallux varus. Clin Podiatr Med Surg. 1991;8(2):367–82.
Edmonds EW, Ek D, Bomar JD, et al. Preliminary radiographic outcomes of surgical correction in juvenile hallux valgus: single proximal, single distal versus double osteotomies. J Pediatr Orthop. 2015;35(3):307–13.
Faber FW, Van Kampen PM, Bloembergen MW. Long-term results of the Hohmann and Lapidus procedure for the correction of hallux valgus: a prospective, randomised trial with eight- to 11-year follow-up involving 101 feet. Bone Joint J. 2013;95-B(9):1222–6.
Fakoor M, Sarafan N, Mohammadhoseini P, et al. Comparison of clinical outcomes of scarf and Chevron osteotomies and the McBride procedure in the treatment of hallux valgus deformity. Arch Bone Joint Surg. 2014;2(1):31–6.
Farrar N, Duncan N, Ahmed N, et al. Scarf osteotomy in the management of symptomatic adolescent hallux valgus. J Child Orthop. 2012;6(2):153–7.
Fokter SK, Podobnik J, Vengust V. Late results of modified Mitchel procedure for the treatment of hallux valgus. Foot Ankle Int. 1999;20(5):296–300.
George HL, Casaletto J, Unnikrishnan PN, et al. Outcome of the scarf osteotomy in adolescent hallux valgus. J Child Orthop. 2009;3:185–90.
Gerbert J, Taynor C, Blue K, et al. Use of mini tightrope for correction of hallux varus deformity. J Foot Ankle Surg. 2011;50:245–51.
Goldman FD, Siegel J, Barton E. Extensor hallucis longus tendon transfer for correction of hallux varus. J Foot Ankle Surg. 1993;32:126–31.
Groningen B, Steen MC, Reijman M, et al. Outcomes in chevron osteotomy for hallux valgus in a large cohort. Foot. 2016;29(2016):18–24.
Gradisek BP, Weil L Jr. Tendon transfers and salvaging options for hallux Varus deformities. Clin Podiatr Med Surg. 2016;33(1):85–98.
Hawkins F. Acquired hallux varus: cause, prevention and correction. Clin Orthop Relat Res. 1971;76:169–76.
Hsu AR, Gross CE, Lin JL. Bilateral hallux varus deformity correction with a suture button construct. Am J Orthop. 2013;42:121–4.
Iyer S, Demetracopoulos CA, Sofka CM, et al. High rate of recurrence following proximal medial opening wedge osteotomy for correction of moderate hallux valgus. Foot Ankle Int. 2015;36(7):756.
Janis LR, Donick II. The etiology of hallux varus: a review. J Am Podiatr Med Assoc. 1975;65:233–7.
Jeuken RM, Schotanus MGM, Kort NP, et al. Long-term follow-up of a randomized controlled trial comparing scarf to Chevron osteotomy in hallux valgus correction. Foot Ankle Int. 2016. doi:10.1177/1071100716639574.
Johnson KA, Spiegel PV. Extensor hallucis longus transfer for hallux varus deformity. J Bone Joint Surg Am. 1984;66:681–6.
Johnson KA, Saltzman CL, Frisca DA. Hallux varus. In: Gould J, editor. Operative foot surgery. Philadelphia: W. B. Saunders.;1994; 1994. p. 28–35.
Juliano PJ, Campbell MA. Tendon transfers about the hallux. Foot Ankle Clin. 2011;16(3):451–69.
Kannegieter E, Kilmartin TE. The combined reverse scarf and opening wedge osteotomy of the proximal phalanx for the treatment of iatrogenic hallux varus. Foot. 2011;21:88–91.
Kilmartin TE, O'Kane C. Combined rotation scarf and Akin osteotomies for hallux valgus: a patient focused 9 year follow up of 50 patients. J Foot Ankle Res. 2010;3(1):2.
Lagaay PM, Hamilton GA, Ford LA, Williams ME, Rush SM, Schuberth JM. Rates of revision surgery using Chevron-Austin osteotomy, Lapidus arthrodesis, and closing base wedge osteotomy for correction of hallux valgus deformity. J Foot Ankle Surg. 2008;47(4):267–72.
Lau JT, Myerson MS. Modified split extensor hallucis longus tendon transfer for correction of hallux varus. Foot Ankle Int. 2002;23(12):1138–40.
Lee KB, Cho NY, Park HW, et al. A comparison of proximal and distal Chevron osteotomy, both with lateral soft-tissue release, for moderate to severe hallux valgus in patients undergoing simultaneous bilateral correction: a prospective randomized controlled trial. Bone Joint J. 2015;97-B(2):202–7.
Lee KT, Park YU, Young KW, et al. Reverse distal chevron osteotomy to treat iatrogenic hallux varus after overcorrection of the intermetatarsal 1–2 angle: technical tip. Foot Ankle Int. 2011;32:89–91.
Leemrijse T, Hoang B, Maldague P, et al. A new surgical procedure for iatrogenic hallux varus: reverse transfer of the abductor hallucis tendon. A report of 7 cases. Acta Orthop Belg. 2008;74:227–34.
Mann RA, Coughlin MJ. Hallux valgus-etiology, anatomy, treatment and surgical considerations. Clin Orthop Relat Res. 1981;157:31–41.
Mauldin DM, Sanders M, Whitmer WW. Correction of hallux valgus with metatarsocuneiform stabilization. Foot Ankle Int. 1990;11:59–66.
Mcbride ED. The conservative operation for “bunion” end results and refinement of technique. J Am Med Assoc. 1935;105(15):1164–8.
Myerson MS, Komenda GA. Results of hallux varus correction using an extensor hallucis brevis tenodesis. Foot Ankle Int. 1996;17:21–7.
Okuda R, Kinoshita M, Yasuda T, et al. Hallux valgus angle as a predictor of recurrence following proximal metatarsal osteotomy. J Orthop Sci. 2011;16:760–4.
Okuda R, Kinoshita M, Yasuda T, et al. Postoperative incomplete reduction of the sesamoids as a risk factor for recurrence of hallux valgus. J Bone Joint Surg Am Ed. 2009;91(7):1637–45.
Okuda R, Kinoshita M, Yasuda T, et al. The shape of the lateral edge of the first metatarsal head as a risk factor for recurrence of hallux valgus. J Bone Joint Surg Am Ed. 2007;89(10):2163–72.
Pentikainen I, Ojala R, Ohtonen P, et al. Preoperative radiological factors correlated to long-term recurrence of hallux valgus following distal Chevron osteotomy. Foot Ankle Int. 2014;35(12):1262–7.
Peterson HA, Newman SR. Adolescent bunion deformity treated with double osteotomy and longitudinal pin fixation of the first ray. J Pediatr Orthop. 1993;13(1):80–4.
Plovanich EJ, Donnenwerth MP, Abicht BP, et al. Failure after soft-tissue release with tendon transfer for flexible iatrogenic hallux varus: a systematic review. J Foot Ankle Surg. 2012;51(2):195–7.
Ravenell RA, Kihm CA, Lin AS, et al. The offset V osteotomy versus the modified Austin with a longer plantar arm: a comparison of mechanical stability. J Foot Ankle Surg. 2011;50(2):201–6.
Richardson EG. Disorders of the hallux. In: Campbell’s operative orthopaedics. 12th ed. Philadelphia: Mosby; 2013. p. 3878–90.
Rochwerger A, Curvale G, Groulier P. Application of bone graft to the medial side of the first metatarsal head in the treatment of hallux varus. J Bone Joint Surg Am. 1999;81:1730–5.
Roukis TS. Nonunion after arthrodesis of the first metatarsal-phalangeal joint: a systematic review. J Foot Ankle Surg. 2011;50(6):710–3.
Saro c, Johnson D, Aragon M, et al. Reliability of radiological and cosmetic measurements in hallux valgus. Acta Radiol. 2005;8:843–51. doi:10.1080/02841850500270852.
Schneider W, Csepan R, Knahr K. Reproducibility of the radiographic metatarsophalangeal angle in hallux surgery. J Bone Joint Surg Am Ed. 2003;85-A(3):494–9.
Schrier JCM, Palmen LN, Verheyen, et al. Patient-reported outcome measures in hallux valgus surgery. A review of literature. Foot Ankle Surg. 2015;21(1):11–5.
Shibuya N, Thorud J, Martin L, et al. Evaluation of hallux valgus correction with versus without Akin proximal phalanx osteotomy. J Foot Ankle Surg. 2016;55(5):910–4.
Skalley TC, Myerson MS. The operative treatment of acquired hallux varus. Cliin Orthop Relat Res. 1994;306:183–91.
Tourne Y, Saragaglia D, Picard F, et al. Iatrogenic hallux varus surgical procedure: a study of 14 cases. Foot Ankle Int. 1995;16:457–63.
Trnka HJ, Zettl R, Hungerford M, et al. Acquired hallux varus and clinical tolerability. Foot Ankle Int. 1997;18:593–7.
Valtin B. Le transfert du premier Interosseus dorsal dans le Traitement Chirurgical de L’Hallux varus iatrogénique. Méd Chir Pied. 1991;7:9–16.
Van Ho H, Safiedine AM, Short T, et al. A comparison of 4 common methods of hand-measured techniques with a computerized technique to measure the first intermetatarsal angle. J Foot Ankle Surg. 2004;43(6):395–9.
Veri JP, Pirani SP, Claridge R. Crescentic proximal metatarsal osteotomy for moderate to severe hallux valgus: a mean 12.2 year follow-up study. Foot Ankle Int. 2001;22(10):817–22.
Yasuda T, Okuda R, Jotoku T, et al. Proximal supination osteotomy of the first metatarsal for hallux valgus. Foot Ankle Int. 2015;36(6):696–704.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Dayton, P.D., Dujela, M., Egdorf, R. (2018). Recurrence and Hallux Varus. In: Dayton, P. (eds) Evidence-Based Bunion Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-60315-5_7
Download citation
DOI: https://doi.org/10.1007/978-3-319-60315-5_7
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-60314-8
Online ISBN: 978-3-319-60315-5
eBook Packages: MedicineMedicine (R0)