Percutaneous Surgery for Mild to Severe Hallux Valgus

Abstract

Percutaneous surgery for hallux valgus correction is increasing in popularity. Third generation techniques under image intensifier control, with rigid internal fixation have improved the reproducibility and reliability of this technique. Percutaneous hallux valgus surgery has been shown to decrease immediate and early postoperative pain compared with open distal osteotomies, with comparable patient reported outcome scores. The transverse osteotomy, under image intensifier guidance gives complete control of metatarsal head correction in all planes of movement. The stability relies on rigid fixation of the first screw in both medial and lateral cortices of the first metatarsal shaft. Accurate screw placement is crucial. Rigid internal fixation allows early full weight-bearing and range of motion exercises, ensuring early return to function. The dorsomedial eminence must be removed to prevent ongoing discomfort. The technique including tips and tricks is described in detail. Level of Evidence: Level II.