Long term clinical results of hallux varus correction by a reversed abductor hallucis transfer

• Published in: Foot and ankle surgery Vol. 26; no. 7; pp. 777 - 783
• Main Authors: Schwagten, Karolien, Vandeputte, Geoffroy, Somville, Johan, Van Hoecke, Emmanuel, Buedts, Kristian
• Format: Journal Article
• Language: English
• Published: France Elsevier Ltd 01.10.2020
• Subjects: Adult; Aged; Female; Follow-Up Studies; Hallux varus; Hallux Varus - physiopathology; Hallux Varus - surgery; Humans; Iatrogenic; Malalignment; Male; Middle Aged; Operative correction; Overcorrection; Patient Satisfaction; Prospective Studies; Range of Motion, Articular - physiology; Tendon Transfer - methods; Time Factors; Young Adult; Malalignment; Iatrogenic; Hallux varus; Overcorrection; Operative correction
• ISSN: 1268-7731; 1460-9584
• DOI: 10.1016/j.fas.2019.10.004

•The currently most favorable technique for the correction of hallux varus is a reverse abductor hallucis tendon transfer.•There is a success satisfaction rate of 69%, which is significantly correlated with alignment.•Initial good short term results are no guarantee for successful long term results, and loss of alignment of 31% is possible on a term of 8 years. Iatrogenic hallux varus is a rare complication after hallux valgus surgery. Operative treatment comprises a wide variety of techniques, of which the reversed transfer of the abductor hallucis tendon is the most recent described technique. This paper will present the long-term clinical results of the reversed transfer of the abductor hallucis longus. Therefore, we performed a prospective clinical observational study on 16 female patients. Our hypothesis is that the tendon transfer will persist in a good alignment and patient satisfaction on long term. There is a 100% follow-up rate with a range from 10 to 101 months. Patients were subjected to a clinical examination, three questionnaires and their general satisfaction. Out of 16 patients, at time of follow-up, we found a positive correlation between the subjective outcome score and alignment (r=0.59), and between the general satisfaction and alignment (r=0.77). Based on the general satisfaction we achieved a success satisfaction rate of 69% (11 patients). The other 31% (5 patients) patient group was only satisfied with major reservations or not satisfied at all. The two most invalidating complications were a coronal or sagittal malalignment or the combination of both. Our results suggest that the reverse abductor hallucis tendon transfer is a good technique to treat a supple iatrogenic hallux varus with an observed success satisfaction rate of 69% at a mean follow-up time of 48 (range 10–101) months. However, patients should be informed that on the long-term loss of correction is possible. Prospective clinical observational study: Level IIb.