Percutaneous, implantless basal closing wedge osteotomy for hallux valgus: Surgical technique and preliminary results in 114 patients

Background: Percutaneous, implantless basal closing wedge osteotomy (PIBCO) is a new technique for hallux valgus (HV) deformity correction that does not need internal fixation. We present this technique and its short-term clinical outcomes for moderate-to-severe HV deformities.Methods: A retrospective review of 162 feet in 114 patients who underwent PIBCO of the first metatarsal (MT1) was conducted. Follow-up averaged 18.5 months. Outcomes were assessed using the visual analog scale (VAS), hallux valgus angle (HVA), intermetatarsal angle (IMA), and radiologic union. Complications were also assessed.Results: Average VAS score improved from 6.2 to 1.0 (P < 0.001). HVA improved from 29.8 degrees to 7.6 degrees (P < 0.001). IMA improved from 14.5 degrees to 6.3 degrees (P < 0.001). A total of 8 major complications were noted (4.9%).Conclusions: Satisfactory HV deformity correction was achieved. However, some instances may require internal fixation in order to avoid complications related to instability and noncompliance of postoperative rehabilitation protocols.(c) 2022 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.