[Surgical approaches and efficacy analysis of hallux valgus deformity in children and adolescents].

OBJECTIVE

To analyze the clinical results of different surgical approaches in treating hallux valgus deformity in children and adolescents.

METHODS

From April 2000 to April 2007, 18 cases of hallux valgus deformity (30 feet) were treated. According to different ages, they were divided into children group (< or = 10 years) and adolescent group (11-18 years). In children group, 4 female patients included 2 bilateral and 2 unilateral hallux valgus deformity (2 left feet, 4 right feet). Each patient underwent a combination of Austin osteotomy and McBride procedure. The American Orthopaedic Foot and Ankle Society-Hallux Metatarsophalangeal Interphalangeal (AOFAS-HMI) score was 55.0 +/- 15.0, and the visual analogue scale (VAS) score was 6.0 +/- 2.0. The hallux valgus angle (HVA) and 1st-2nd intermetatarsal-phalangeal angle (IMA) were (35.0 +/- 4.0) degrees and (14.4 +/- 2.0) degrees. In adolescent group, 14 patients included 3 males (4 feet) and 11 females (20 feet), 10 bilateral and 4 unilateral hallux valgus deformity (10 left feet, 14 right feet). Each patient underwent the modified Mitchell osteotomy. The AOFAS-HMI score was 55.6 +/- 14.0, and the VAS score was 7.0 +/- 1.0. The HVA and IMA were (38.5 +/- 5.0) degrees and (15.0 +/- 3.0) degrees.

RESULTS

All incisions healed primarily. The patients of two groups were followed up 12-32 months (21 months on average). In adolescent group, pain of metatarsophalangeal joint occurred in 1 case and the symptom disappeared after 3-month physical therapy; 1 case recurred after 21 months of operation and achieved satisfactory results after Lapidus operation. In children group, the AOFAS-HMI score was 92.1 +/- 5.0, the VAS score was 1.0 +/- 0.6, HVA was (14.7 +/- 3.0) degrees, and IMA was (5.5 +/- 2.0) degrees; showing significant differences (P < 0.05) when compared with those before operation. In adolescent group, the AOFAS-HMI score was 90.0 +/- 6.0, the VAS score was 1.0 +/- 0.6, HVA was (13.7 +/- 3.0) degrees, and IMA was (6.8 +/- 2.0) degrees; showing significant differences (P < 0.05) when compared with those before operation.

CONCLUSION

It has the advantages of rapid bone healing, short course of treatment, and less complication to treat hallux valgus deformity in children with a combination of Austin osteotomy and McBride procedure and in adolescent with the modified Mitchell osteotomy.