Abstract
The aim of this study is to evaluate the outcomes of the surgical treatment in patients with osteoporosis with moderate or severe hallux valgus regarding the correction of Hallux Valgus Angle (HVA) and Intermetatarsal Angle (IMA) compared to non-osteoporotic patients.
Materials and Methods: The timeline of the study was from 2015 to 2020 with 20 patients with the mean age of 61.6±4.1 within the osteoporotic group and 63.5±5.0 within the non-osteoporotic group. 12 osteotomies in osteoporotic patients and eight osteotomies in non-osteoporotic patients were seen at follow-up after 2 years after surgery. Preoperative bone density of T-Score 2.5 SD or more below is named osteoporosis and IMA and was used to define patient groups; mild hallux valgus was defined with IMA of 11-16 degrees, moderate hallux valgus was defined with IMA from 16 to twenty degrees, and severe hallux valgus was defined with IMA from 20 degrees or more.
Results: No statistical differences were found in HVA, IMA and between the osteoporotic patients and non-osteoporotic patients preoperatively, postoperatively, and therefore the final follow-up in mild to moderate hallux valgus. The mean AOFAS score ameliorated from 52.6 preoperatively to 89.1. Regarding satisfaction, ~ 83 you look after patients were very satisfied or satisfied. No evidence of complications and every one of the patients resulted with complete union of the osteotomy.
Conclusion: We believed that the surgical treatment is a safe, effective procedure for the correction of elderly patients with osteoporosis. In patients with moderate and severe hallux valgus the results of osteotomy have not any specific difference between the osteoporotic and non-osteoporotic groups
References
S.S.Suresh. Scarf osteotomy - Is it the procedure of choice in hallux valgus surgery? A preliminary report. Oman Med J. 2007 Oct;22(3):47-50. PMID: 22400093; PMCID: PMC3294152.
Bock P, Lanz U, Kröner A, Grabmeier G, Engel A. The Scarf osteotomy: a salvage procedure for recurrent hallux valgus in selected cases. Clin Orthop Relat Res. 2010 Aug;468(8):2177-87. doi: 10.1007/s11999-010-1363-z. Epub 2010 May 22. PMID: 20496024; PMCID: PMC2895827.
Ruci J, Ruci V, Duni A. Current trends in Hallux Valgus surgical treatment. Alban Med J 2016; 2:102-7.
Ruci, J., & Gjika, E. (2022). Moderate to Severe Hallux Valgus Deformities. Surgical treatment with SCARF Osteotomy Technique. Albanian Journal of Trauma and Emergency Surgery, 6(1), 989-994. https://doi.org/10.32391/ajtes.v6i1.179
Hujazi I, Yassa R, Sevenoaks H, Khalfaoui M, Barrie J. Hallux valgus interphalangeus: reliability of radiological assessment. Foot Ankle Surg. 2019 Aug;25(4):507-510. doi: 10.1016/j.fas.2018.03.005. Epub 2018 Mar 28. PMID: 30321956.
Osteoporosis - primary prevention; NICE Technology Appraisals, January 2011
Ferdous, HS & Afsana, Faria & Qureshi, Nazmul & Rouf, Rushda. (2016). Osteoporosis: A Review. BIRDEM Medical Journal. 5. 30. 10.3329/birdem.v5i1.28371.
Ruci, J., & Selmani, E. (2022). Actual tendencies of Hallux Valgus surgical treatment. Albanian Journal of Trauma and Emergency Surgery, 6(1), 939-943. https://doi.org/10.32391/ajtes.v6i1.264
Selmani, E., Brahimi, F., Duraj, L., Selmani, V., Syko, G., & Karanca, I. (2018). Minimally Invasive Hallux Valgus Surgery. A Systematic Review. Albanian Journal of Trauma and Emergency Surgery, 2(2), 91-98. https://doi.org/10.32391/ajtes.v2i2.5
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