Long-term outcomes of hallux valgus treated by the suturing of fascial flap of bursa of hallux with the tendon of adductor hallucis

Abstract

Objective To evaluate the long-term clinical effect of adductor pollicis and pollicis sac fascial flap anastomosis for hallux valgus. Methods Data 12 cases with hallux valgus who who were treated by adductor pollicis and pollicis sac fascial flap anastomosis from April 1993 to November 1996 and were followed up for more than 19 years were retrospectively analyzed. All the patients were female with an average age of 43.6±7.6 years old (range, 24-56 years). HVA, IMA, and tibial sesamoid position (TSP) were measured by foot X-ray and compared between presurgery, 4 years postsurgery and 19 years postsurgery. The American Orthopaedic Foot and Ankle Society (AOFAS), hallux metatarsophalangeal joints, interphalangeal joint function scores were used to evaluatethe foot function. Patient satisfactions were investigated by Glynn's comprehensive clinical evaluation and hallux score. Results Average preoperative HVA was 30.68°±9.71°, and average 1st and 2nd IMA was 12.92°±4.02°. Average HVA 4 years and 19 years post-op were 24.62°±7.61° and 21.47°±6.52°, and average 1st and 2nd IMA were 7.32°±3.21° and 6.15°±2.92°, which were significantly less than those of pre-surgery. Average TSP was 4.46±1.03, average TSP 4 years and 19 years post-op were 2.01±0.75 and 1.79±0.62, which were significantly less than those of pre-surgery. There was no significant difference between 4 years and 19 years post-op. The incidence of plantar anterior callus was 95.2% (20/21); the incidence of pain was 85.7% (18/21), and the number of the corpus callosum was significantly reduced 19 year post-op. Only 1 foot had painful callus under the head of third metatarsal, and the rest of the corpus callosum were painless; the incidence of the corpus callosum was 33.3% (7/21); the incidence of pain of the corpus callosum was 4.7% (1/21); the incidence of pain of the corpus callosum was 4.7%, and patients with long-term improvement of the effect of the corpus callosum was significantly better than preoperative. The results of postoperative follow-up Glynn comprehensive clinical evaluation were 16 excellent feet, 2 good feet, 3 poor feet, and the excellent rate was 88.5% (18/21); the results of Glynn toe evaluation were 18 excellent feet, 3 good feet, and the excellent rate was 100%. Conclusion The adductor pollicis and pollicis sac fascial flap anastomosis in the treatment of hallux valgus can obtain good short-term and long-term clinical efficacy, by which postoperative hallux valgus deformity is excellently corrected, and the rate of patient satisfaction is high. Key words: Foot; Hallux valgus; Follow-up studies