Clinical Outcomes of Proximal Metatarsal Closed-Wedge Osteotomy Using Compression Staples and Headless Screw Fixation for Hallux Valgus With Concomitant Lesser Toe Surgeries.

BACKGROUND

Hallux valgus (HV) is a prevalent forefoot deformity that often needs corrective surgery to alleviate pain, improve footwear compatibility, and enhance gait function. Proximal metatarsal osteotomy (PMO) is commonly performed for moderate to severe HV; however, the fixation method for the osteotomy site is still debatable. Additionally, HV correction is frequently accompanied by concomitant lesser toe surgeries, which may lead to increased risks of wound complications and residual symptoms. This study aimed to evaluate the clinical and radiographic outcomes of PMO using a combination of compression staple and screw fixation.

METHODOLOGY: A retrospective review of 56 feet in 46 patients (mean age: 65.1 ± 13.6 years) treated with PMO using compression staple and screw fixation was conducted. Clinical outcomes were assessed using the Japanese Society for Surgery of the Foot (JSSF) scale and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q). Radiographic parameters were analyzed preoperatively and at final follow-up.

RESULTS

The mean follow-up period was 18.5 ± 7.4 months. Significant improvements were observed in JSSF scores and all SAFE-Q subscales postoperatively in isolated PMO and multiple lesser toe surgeries. Radiographic analyses demonstrated significant correction of the HV angle, first-second intermetatarsal angle, and first-fifth intermetatarsal angle. No nonunion or major adverse events were recorded, and the recurrence rate was 3.6%.

CONCLUSIONS

Postoperative results were good when osteotomy of the metatarsal bone was performed with compression staples and screw fixation. The use of compression staples offers the advantages of persistent compression, reduced invasiveness, and shorter operative time, making it a viable option for HV correction.