Hallux Valgus Correction in the Elderly Population: Is It That Bad?

Background:
Hallux valgus is the most common deformity of the foot. Treatment options vary but usually includes some kind of osteotomy. For severe HV and elderly patients MTPJ1 fusion might be considered, although the functional outcomes of osteotomies are better. In order to contradict this hypothesis, we compared osteotomy success rate in old people compared to young people. We hypothesize that there will be no difference in the surgical outcome (radiographically and clinically) of osteotomies comparing young and old people.

Patients and Methods:
A retrospective computerized study was conducted between the years 2010-2019. Inclusion criteria was patient over the age of 50 undergoing HV correction, had foot X-rays before and 6 weeks after the surgery and had clinical follow up. Secondary outcome was days of hospitalization and immediate complications

Results:
Comparing young (<65, n=41) and elderly (>65, n=30) patient groups, we see that the pre-osteotomy angles averages are almost identical (HVA 33.61 vs 34.11, IMA 13.19 vs. 13.16, P=NS), as the post-op measurements (HVA 17.49 vs 17.48, IMA 7.64 vs. 7.67, P=NS). Early recurrence and fusion rates were found to be the same. The average number of hospitalization days after surgery was higher in the older group, 0.63 vs. 0.1 days (P<0.05) but the number of post-surgical complications wasn`t higher in the young group, 0.34 vs. 0.16 (P=NS).

Conclusions:
Elderly`s HV can be surgically corrected successfully by osteotomy, just as in younger patients. With the same rate of osteotomy success as measured by radiological angle. Moreover, we noticed that the rate of post- operative complications was not higher in the older group, but they had longer hospital stay. Nonetheless, this is a small scale study, which requires further investigation. Furthermore, comparison between osteotomy to fusion in the elderly populations should be sought.