Published and Unpublished Complications in Hallux Valgus Surgery

Hallux valgus (HV) deformity operative correction for medical indications and cosmetic purposes are the most common procedures in Foot & Ankle Surgery.

The estimated incidence of HV deformity is 23% in adults aged 18–65 years and 35.7% in patients over 65 years (Trnka HJ, 2005).

There are more than a hundred different surgical methods to correct this deformity, most of them by performing first metatarsal and/or proximal phalanx osteotomies. The selection of an optimal surgical strategy is controversial. Since there is no one specific procedure to solve all the various pathological changes, the rate of dissatisfied patients postoperatively is still very high as 25%-33% (Fleisher AE, et al. 2014).

As with any procedure, there are complications which may arise following surgery. The rate of complications in hallux valgus surgery ranges from 10% to 55% (Scioli MW, 1997). The complication that are directly from the corrective procedures may include: infection; impaired wound healing; hypertrophic scar; reduction of 1MTPJ ROM; prolonged pain; metatarsal pain (transfer lesion); complex regional pain syndrome (CRPS); nerve damage and irritation; transection of FHL; avascular necrosis (AVN); recurrence of the deformity; over correction (Hallux Varus); nonunion and/or malunion of the metatarsal & phalangeal osteotomies; pseudarthrosis; hardware failure.

Some of the complications are not amenable to corrective treatment.

During the last 25 years patient came to me seeking medical advice after failed HV repair, some of them with complications that are not published in our literature.

I would like to present several of these cases with complication that are not published yet in the medical literature.