Shortening first metatarsal osteotomies for hallux rigidus – Is there a place for them? A systematic review

Casais I.; Huertas J.; Cerqueira R.; Diaz T.; Oliva X.M. · Foot and Ankle Surgery (2023) · DOI: 10.1016/j.fas.2022.10.003

Resumen

Background: Evidence-based recommendations for shortening first metatarsal osteotomies as joint-preserving procedures for hallux rigidus are insufficient. Because these surgeries continue to be widely used, we aimed to evaluate their published outcomes and complications. Methods: Through a systematic review, we critically analyzed 7 articles, including 444 feet submitted to Youngswick-type or distal oblique osteotomies. Results: High patient satisfaction and statistically significant improvement in outcome scores and range of motion was demonstrated by most authors. Transfer metatarsalgia was the most common complication, but surgical management was rarely needed. Although no significant differences in outcomes were found according to the stage of hallux rigidus, we believe these osteotomies are not adequate for stage 4 of Coughlin and Shurnas classification. Conclusions: Shortening first metatarsal osteotomies can be an alternative to arthrodesis in stage 2 (and eventually 3) hallux rigidus, as they appear effective and safe. However, further prospective and comparative studies are required.