Long-term follow-up of hallux valgus surgery in patients with down's syndrome: a case series.

PURPOSE: The aim of our study is to describe the long-term radiological and functional results of hallux valgus (HV) surgery in a series of adult patients with Down syndrome (DS). As far as we know, no other studies have been published regarding this topic.

METHODS

A retrospective study was conducted on a case series of patients with DS who underwent surgery for HV at our institution with a minimum follow-up of 2 years. Pre- and postoperative radiological outcomes (HVA and IMA); functional outcomes using the American Orthopaedic Foot and Ankle Society-MetaTarsoPhalangeal-InterPhalangeal Scale (AOFAS-MTP-IP); health-related quality of life outcomes using the Manchester-Oxford Foot Questionnaire (MOXFQ) and the EuroQol Five Dimensions tool (EQ-5D-5L); pain using the Visual Analogue Scale (VAS) and complication and reoperation rates were assessed.

RESULTS

The study included seven patients (9 feet). The median age at surgery was 39 (range 27-41.5) years, and the median follow-up was 10.7 (range 3.7-15.2) years. One year after surgery, there was a statistically significant improvement in radiological outcomes, with a median HVA and IMA correction of 12.5 (11.3-22.5) and 12.0 (11.4-17.7) degrees, respectively, and a correction loss of 3.9 (0.8-6.9) and 0.6 (0.2-1.1) degrees at the end of follow-up. The median AOFAS-MTP-IP scale score was 71.0 points (63.0-78.5). The median global MOXFQ score was 28.1 (7.8-43.7). During follow-up, four patients required surgical revision. At the end of follow-up, the median VAS score was 0 (0-4) and only one patient had problems with footwear.

CONCLUSION

Surgical treatment of HV in patients with DS provides acceptable radiological results with excellent functional outcomes, although a high rate of reoperation has been observed.