A meta-analysis of comparative clinical studies of isolated osteotomy versus osteotomy with lateral soft tissue release in treating hallux valgus

Background: Contradictory results have been reported in the literature over the beneficial effect of the lateral soft tissue release (LSTR) when associated to an osteotomy for the treatment of hallux valgus (HV). Materials and methods: Six comparative studies totalizing 425 patients (549 feet) were computed and comparing two groups: one group of patients having osteotomy alone and the other group having osteotomy with LSTR. Results: Subgroup analysis in relation to the type of LSTR yielded significant better HVA correction (P < 0.0001) in favor of those reporting the release of the lateral sesamoido-metatarsal ligament (LSML). A moderate significance (P = 0.03) of the inter-metatarsal angle (IMA) difference was found in favor of LSTR. Conclusions: There could be a beneficial effect of transecting LSML in all cases of HV deformity, and a probable efficacy of an added adductor hallucis tendon transection when the deformity is moderate to severe. (C) 2018 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.