COMPLICATIONS IN PERCUTANEOUS SURGERY OF THE FOREFOOT

Abstract

Introduction and Objectives: The aim of this report is to present the complications that occur with percutaneous surgery for hallux valgus. Percutaneous surgery is based on a series of combined surgical procedures designed to resolve a deformity.

Materials and Methods: We have reviewed the first 200 cases of percutaneous surgery in our centre. In 136 cases, a diagnosis of hallux valgus was made in association with metatarsalgia and deformity of the toes. There were 40 cases of hallux valgus alone, 24 cases of metatarsal-gias with toe deformities, and 10 cases of toe deformities alone. Patients were treated between February 2001 and February 2002 with a mean follow-up time of 8 months. Complications were analysed clinically and radiographically.

Results: We found the following complications: 4 cases of insufficient bunionectomy, 5 cases of dysesthesia of the first digit, 12 cases of transfer metatarsalgia, 10 cases of asymptomatic metatarsal non-union, 20 cases of superficial infections, 50% of cases with prolonged edema of the foot, and 90% of cases with pain on the dorsum of the foot lasting 3–4 months in cases of meta-tarsalgia. Other less common complications included the following: 1 case of deep vein thrombosis, 1 case of cutaneous necrosis in the area of the anaesthetic block, and 1 case of anterior tibial dysesthesia at the level of the anesthetic block. Repeat treatment was required by 10% of patients.

Discussion and Conclusions: Percutaneous surgery is an alternative to conventional surgery. Advantages included decreased postoperative pain, a rapid return to daily activities, weight-bearing ability in the immediate postoperative period, and the fact that is it a standing surgery. However, it should be remembered that this method is not without its possible complications, which may require repeat treatment.