Radiological and Clinical Outcome After Reversed L-Shaped Osteotomy: A Large Retrospective Swiss Cohort Study

J Foot Ankle Surg. 2019 Jan;58(1):86-92. doi: 10.1053/j.jfas.2018.08.004.

Abstract

The objective was to report radiological and clinical outcomes after reversed L-shaped osteotomy (ReveL) for hallux valgus (HV). A retrospective cohort study was performed between January 2004 and December 2013. The primary outcome was radiological recurrence of HV (HV angle [HVA] >15°). There were various exposure and secondary outcome variables. The results showed a median follow-up of 12.0 months (N = 827). Radiological recurrence, limited patient satisfaction, complication, revision surgery, and elective hardware removal were found in 25.0%, 15.3%, 4.6%, 2.5%, and 26.7%. Median pre- to postoperative changes were highest for HVA (delta = -16.7°). Recurrence was more likely in cases with preoperative HVA ≥40° (adjusted odds ratio [ORadjusted]) 3.63, p < .001). Revisions were more likely with concomitant diseases and bilateral surgery (ORadjusted 12.53, p = .010; ORadjusted 3.35, p = .030). Hardware removal was less likely in patients ≥50 years (ORadjusted 0.67, p = .014). In conclusion, ReveL was a good surgical option for HV because of the relatively low rates of unfavorable outcomes.

Keywords: hallux valgus deformity (HV); limited patient satisfaction; long plantar arm osteotomy; orthopaedic surgery; radiological recurrence; reversed L-shaped osteotomy (ReveL); surgical technique.

MeSH terms

  • Adult
  • Aged
  • Female
  • Hallux Valgus / diagnostic imaging
  • Hallux Valgus / surgery*
  • Humans
  • Male
  • Middle Aged
  • Osteotomy*
  • Patient Satisfaction
  • Patient Selection
  • Radiography
  • Recurrence
  • Reoperation
  • Retrospective Studies
  • Switzerland
  • Treatment Outcome