- Department of Foot and Ankle Surgery, the Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, P. R. China;
SHI Zhongmin,
Email: szm1972@sjtu.edu.cn
Severe hallux valgus, a triplanar foot deformity significantly impairing patients' quality of life, has witnessed progressive advancements in surgical management. This article systematically reviews the therapeutic progress through literature analysis, encompassing modifications of conventional surgical procedures, novel techniques, and applications of innovative biomaterials. A critical analysis and discussion of these technological advancements and future developmental directions are presented to provide valuable insights and references for clinical management of severe hallux valgus.
Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
| 1. | Hecht PJ, Lin TJ. Hallux valgus. Med Clin North Am 2014, 98(2): 227-232. |
| 2. | Perera AM, Mason L, Stephens MM. The pathogenesis of hallux valgus. J Bone Joint Surg (Am), 2011, 93(17): 1650-1661. |
| 3. | Coughlin MJ, Jones CP. Hallux valgus: demographics, etiology, and radiographic assessment. Foot Ankle Int 2007, 28(7): 759-777. |
| 4. | 王正义, 姜保国, 唐康来, 等. 踇外翻外科治疗专家共识. 中华骨与关节外科杂志 2018, 11(2): 87-95. |
| 5. | Ying J, Xu Y, István B, et al. Adjusted indirect and mixed comparisons of conservative treatments for hallux valgus: a systematic review and network meta-analysis. Int J Environ Res Public Health, 2021, 18(7): 3841. doi: 10.3390/ijerph18073841. |
| 6. | Menz HB, Lim PQX, Hurn SE, et al. Nonsurgical management of hallux valgus: findings of a randomised pilot and feasibility trial. J Foot Ankle Res, 2023, 16(1): 78. doi: 10.1186/s13047-023-00677-1. |
| 7. | Plaass C, Karch A, Koch A, et al. Short term results of dynamic splinting for hallux valgus—A prospective randomized study. Foot Ankle Surg, 2020, 26(2): 146-150. |
| 8. | Chuckpaiwong B. Comparing proximal and distal metatarsal osteotomy for moderate to severe hallux valgus. Int Orthop, 2012, 36(11): 2275-2278. |
| 9. | Monteagudo M, Martínez-de-Albornoz P. Management of complications after hallux valgus reconstruction. Foot Ankle Clin, 2020, 25(1): 151-167. |
| 10. | Raikin SM, Miller AG, Daniel J. Recurrence of hallux valgus: a review. Foot Ankle Clin, 2014, 19(2): 259-274. |
| 11. | Peng YN, Peng YH, Chen CPC. Chevron osteotomy and scarf osteotomy for hallux valgus angle and intermetatarsal angle correction: a systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res, 2024, 19(1): 566. doi: 10.1186/s13018-024-05007-0. |
| 12. | Tsikopoulos K, Papaioannou P, Kitridis D, et al. Proximal versus distal metatarsal osteotomies for moderate to severe hallux valgus deformity: a systematic review and meta-analysis of clinical and radiological outcomes. Int Orthop, 2018, 42(8): 1853-1863. |
| 13. | Füssenich W, Seeber GH, Zwoferink JR, et al. Non-union incidence of different joint preparation types, joint fixation techniques, and postoperative weightbearing protocols for arthrodesis of the first metatarsophalangeal joint in moderate-to-severe hallux valgus: a systematic review. EFORT Open Rev, 2023, 8(3): 101-109. |
| 14. | Barg A, Harmer JR, Presson AP, et al. Unfavorable outcomes following surgical treatment of hallux valgus deformity: a systematic literature review. J Bone Joint Surg (Am), 2018, 100(18): 1563-1573. |
| 15. | 何至, 孙宁, 杨晓松, 等. 采用改良Chevron截骨术治疗重度拇外翻的中期疗效观察. 骨科临床与研究杂志, 2024, 9(5): 294-301. |
| 16. | 余建华, 方添顺, 宋涛, 等. 改良Chevron截骨术治疗中重度足拇外翻. 中国骨伤, 2022, 35(1): 90-94. |
| 17. | 林建辉, 郑明, 赵梁, 等. Chevron截骨联合第一跖骨基底开放截骨治疗重度踇外翻的疗效分析. 福建医药杂志, 2023, 45(1): 30-33. |
| 18. | 庄宇嘉, 刘建全, 李文翠, 等. 跖骨近端截骨矫正踇外翻的研究进展. 足踝外科电子杂志 2022, 9(2): 91-99. |
| 19. | 刘吉帅, 韩婷婷, 张智超, 等. Scarf截骨术治疗足拇外翻畸形的临床研究进展. 临床医学研究与实, 2024, 9(36): 195-198. |
| 20. | Schuh R, Willegger M, Holinka J, et al. Angular correction and complications of proximal first metatarsal osteotomies for hallux valgus deformity. Int Orthop, 2013, 37(9): 1771-1780. |
| 21. | Vasso M, Del Regno C, D'Amelio A, et al. A modified Austin/chevron osteotomy for treatment of hallux valgus and hallux rigidus. J Orthop Traumatol, 2016, 17(1): 89-93. |
| 22. | Badekas A, Georgiannos D, Lampridis V, et al. Proximal opening wedge metatarsal osteotomy for correction of moderate to severe hallux valgus deformity using a locking plate. Int Orthop, 2013, 37(9): 1765-1770. |
| 23. | Baertich C, Tablante AJC, Tablante EB, et al. Percutaneous, implantless basal closing wedge osteotomy for hallux valgus: Surgical technique and preliminary results in 114 patients. Foot Ankle Surg, 2022, 28(7): 1083-1088. |
| 24. | 庄宇嘉, 王光辉, 陈小强, 等. 第1跖骨近端推移截骨治疗中重度足踇外翻. 中国矫形外科杂志, 2025, 33(6): 557-560. |
| 25. | Castioni D, Fanelli D, Gasparini G, , et al. Scarf osteotomy for the treatment of moderate to severe hallux valgus: Analysis of predictors for midterm outcomes and recurrence. Foot Ankle Surg, 2020, 26(4): 439-444. |
| 26. | Li Z, Yu W, Lin S, et al. Comparative effects of modified rotary scarf osteotomy and traditional scarf osteotomy in treating moderate to severe hallux valgus: a retrospective cohort study. BMC Musculoskelet Disord, 2024, 25(1): 61. doi: 10.1186/s12891-023-07156-5. |
| 27. | 石守印, 周敏, 海拉提·巴合提, 等. 单切口Scarf旋转截骨联合外侧软组织松解术在中重度拇外翻畸形中的疗效分析. 生物骨科材料与临床研究, 2025, 22(2): 71-74+80. |
| 28. | 王超, 王智, 孙超, 等. 改良卡槽单钉Scarf截骨术与传统Scarf截骨术治疗足拇外翻畸形效果的比较. 中华解剖与临床杂志, 2023, 28(7): 423-430. |
| 29. | Basile A, Battaglia A, Campi A. Retrospective analysis of the Ludloff osteotomy for correction of severe hallux valugs deformity. Foot and Ankle Surgery, 2001, 7(1): 1-8. |
| 30. | Castaneda DA, Myerson MS, Neufeld SK. The Ludloff osteotomy: a review of current concepts. Int Orthop, 2013, 37(9): 1661-1668. |
| 31. | Robinson AH, Bhatia M, Eaton C, et al. Prospective comparative study of the scarf and Ludloff osteotomies in the treatment of hallux valgus. Foot Ankle Int, 2009, 30(10): 955-963. |
| 32. | 殷大利, 初娇, 纪祥, 等. 第一跖骨干Scarf截骨结合趾骨Akin截骨治疗中重度踇外翻的短期效果. 精准医学杂志, 2021, 36(6): 541-543. |
| 33. | Li C, Lu L, Zhang Y, et al. F-Shaped osteotomy combined with basal opening wedge osteotomy for severe hallux valgus. Orthop Surg, 2019, 11(4): 604-612. |
| 34. | Symeonidis PD, Anderson JG. Original and modified lapidus procedures: proposals for a new terminology. J Bone Joint Surg (Am), 2021, 103(4): e15. doi: 10.2106/JBJS.20.01010. |
| 35. | Jackson JB, Kennedy B, Deal P, et al. The surgical learning curve for modified lapidus procedure for hallux valgus deformity. Foot Ankle Spec, 2024, 17(1): 9-13. |
| 36. | Santrock RD, Smith B. Hallux valgus deformity and treatment: A three-dimensional approach: modified technique for lapidus procedure. Foot Ankle Clin 2018, 23(2): 281-295. |
| 37. | 李大成, 王青松, 宋传航, 等. 改良Lapidus截骨术第1跖楔关节单平面截骨联合第1跖骨下移治疗拇外翻的疗效分析. 生物骨科材料与临床研究, 2024, 21(3): 53-57+63. |
| 38. | Anderson MR, Ho BS, Baumhauer JF. Republication of "Current concepts review: hallux rigidus". Foot Ankle Orthop 2023, 8(3): 24730114231188123. doi: 10.1177/24730114231188123. |
| 39. | McGaver RS, Attia AK, Seiffert KJ, et al. Comparative study of staples vs plate and screws for arthrodesis of the first metatarsophalangeal joint. Foot Ankle Orthop 2024, 9(4): 2473011424S00194. doi: 10.1177/2473011424S00194. |
| 40. | Duff JR, Alecxih AG, White CC, et al. Minimally invasive first metatarsophalangeal joint arthrodesis with a low-profile hybrid locking plate and a beveled compression screw: a surgical technique. Foot Ankle Spec, 2025. doi: 10.1177/19386400251331648. |
| 41. | Lui TH. Arthroscopic arthrodesis of the first metatarsophalangeal joint in hallux valgus deformity. Arthrosc Tech, 2017, 6(5): e1481-e1487. |
| 42. | 潘旭月, 王梅青, 陶经纬, 等. 第一跖趾关节融合术与第一跖趾关节置换术治疗进展性踇僵硬的Meta分析. 足踝外科电子杂志, 2020, 7(1): 29-33. |
| 43. | Kitaoka HB, Patzer GL. Arthrodesis versus resection arthroplasty for failed hallux valgus operations. Clin Orthop Relat Res, 1998(347): 208-214. |
| 44. | Artioli E, Mazzotti A, Zielli S, et al. Keller's arthroplasty for hallux rigidus: A systematic review. Foot Ankle Surg, 2022, 28(4): 526-533. |
| 45. | 刘卫刚, 马亮, 张子景, 等. 第1跖趾关节融合术联合跖趾关节成形术治疗老年拇外翻. 临床骨科杂志, 2019, 22(6): 712-715. |
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| 51. | Li G, Zhang H, Wang X, et al. Clinical guideline on the third generation minimally invasive surgery for hallux valgus. J Orthop Translat, 2024, 45: 48-55. |
| 52. | Lui TH, Li CCH, Chan SK, et al. Modified endoscopic distal soft tissue procedure (mEDSTP) and arthroscopic lapidus arthrodesis for correction of severe hallux valgus. Arthrosc Tech 2023, 12(10): e1779-e1787. |
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| 54. | Lewis TL, Ray R, Robinson P, et al. Percutaneous Chevron and Akin (PECA) osteotomies for severe hallux valgus deformity with mean 3-year follow-up. Foot Ankle Int, 2021, 42(10): 1231-1240. |
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- 1. Hecht PJ, Lin TJ. Hallux valgus. Med Clin North Am 2014, 98(2): 227-232.
- 2. Perera AM, Mason L, Stephens MM. The pathogenesis of hallux valgus. J Bone Joint Surg (Am), 2011, 93(17): 1650-1661.
- 3. Coughlin MJ, Jones CP. Hallux valgus: demographics, etiology, and radiographic assessment. Foot Ankle Int 2007, 28(7): 759-777.
- 4. 王正义, 姜保国, 唐康来, 等. 踇外翻外科治疗专家共识. 中华骨与关节外科杂志 2018, 11(2): 87-95.
- 5. Ying J, Xu Y, István B, et al. Adjusted indirect and mixed comparisons of conservative treatments for hallux valgus: a systematic review and network meta-analysis. Int J Environ Res Public Health, 2021, 18(7): 3841. doi: 10.3390/ijerph18073841.
- 6. Menz HB, Lim PQX, Hurn SE, et al. Nonsurgical management of hallux valgus: findings of a randomised pilot and feasibility trial. J Foot Ankle Res, 2023, 16(1): 78. doi: 10.1186/s13047-023-00677-1.
- 7. Plaass C, Karch A, Koch A, et al. Short term results of dynamic splinting for hallux valgus—A prospective randomized study. Foot Ankle Surg, 2020, 26(2): 146-150.
- 8. Chuckpaiwong B. Comparing proximal and distal metatarsal osteotomy for moderate to severe hallux valgus. Int Orthop, 2012, 36(11): 2275-2278.
- 9. Monteagudo M, Martínez-de-Albornoz P. Management of complications after hallux valgus reconstruction. Foot Ankle Clin, 2020, 25(1): 151-167.
- 10. Raikin SM, Miller AG, Daniel J. Recurrence of hallux valgus: a review. Foot Ankle Clin, 2014, 19(2): 259-274.
- 11. Peng YN, Peng YH, Chen CPC. Chevron osteotomy and scarf osteotomy for hallux valgus angle and intermetatarsal angle correction: a systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res, 2024, 19(1): 566. doi: 10.1186/s13018-024-05007-0.
- 12. Tsikopoulos K, Papaioannou P, Kitridis D, et al. Proximal versus distal metatarsal osteotomies for moderate to severe hallux valgus deformity: a systematic review and meta-analysis of clinical and radiological outcomes. Int Orthop, 2018, 42(8): 1853-1863.
- 13. Füssenich W, Seeber GH, Zwoferink JR, et al. Non-union incidence of different joint preparation types, joint fixation techniques, and postoperative weightbearing protocols for arthrodesis of the first metatarsophalangeal joint in moderate-to-severe hallux valgus: a systematic review. EFORT Open Rev, 2023, 8(3): 101-109.
- 14. Barg A, Harmer JR, Presson AP, et al. Unfavorable outcomes following surgical treatment of hallux valgus deformity: a systematic literature review. J Bone Joint Surg (Am), 2018, 100(18): 1563-1573.
- 15. 何至, 孙宁, 杨晓松, 等. 采用改良Chevron截骨术治疗重度拇外翻的中期疗效观察. 骨科临床与研究杂志, 2024, 9(5): 294-301.
- 16. 余建华, 方添顺, 宋涛, 等. 改良Chevron截骨术治疗中重度足拇外翻. 中国骨伤, 2022, 35(1): 90-94.
- 17. 林建辉, 郑明, 赵梁, 等. Chevron截骨联合第一跖骨基底开放截骨治疗重度踇外翻的疗效分析. 福建医药杂志, 2023, 45(1): 30-33.
- 18. 庄宇嘉, 刘建全, 李文翠, 等. 跖骨近端截骨矫正踇外翻的研究进展. 足踝外科电子杂志 2022, 9(2): 91-99.
- 19. 刘吉帅, 韩婷婷, 张智超, 等. Scarf截骨术治疗足拇外翻畸形的临床研究进展. 临床医学研究与实, 2024, 9(36): 195-198.
- 20. Schuh R, Willegger M, Holinka J, et al. Angular correction and complications of proximal first metatarsal osteotomies for hallux valgus deformity. Int Orthop, 2013, 37(9): 1771-1780.
- 21. Vasso M, Del Regno C, D'Amelio A, et al. A modified Austin/chevron osteotomy for treatment of hallux valgus and hallux rigidus. J Orthop Traumatol, 2016, 17(1): 89-93.
- 22. Badekas A, Georgiannos D, Lampridis V, et al. Proximal opening wedge metatarsal osteotomy for correction of moderate to severe hallux valgus deformity using a locking plate. Int Orthop, 2013, 37(9): 1765-1770.
- 23. Baertich C, Tablante AJC, Tablante EB, et al. Percutaneous, implantless basal closing wedge osteotomy for hallux valgus: Surgical technique and preliminary results in 114 patients. Foot Ankle Surg, 2022, 28(7): 1083-1088.
- 24. 庄宇嘉, 王光辉, 陈小强, 等. 第1跖骨近端推移截骨治疗中重度足踇外翻. 中国矫形外科杂志, 2025, 33(6): 557-560.
- 25. Castioni D, Fanelli D, Gasparini G, , et al. Scarf osteotomy for the treatment of moderate to severe hallux valgus: Analysis of predictors for midterm outcomes and recurrence. Foot Ankle Surg, 2020, 26(4): 439-444.
- 26. Li Z, Yu W, Lin S, et al. Comparative effects of modified rotary scarf osteotomy and traditional scarf osteotomy in treating moderate to severe hallux valgus: a retrospective cohort study. BMC Musculoskelet Disord, 2024, 25(1): 61. doi: 10.1186/s12891-023-07156-5.
- 27. 石守印, 周敏, 海拉提·巴合提, 等. 单切口Scarf旋转截骨联合外侧软组织松解术在中重度拇外翻畸形中的疗效分析. 生物骨科材料与临床研究, 2025, 22(2): 71-74+80.
- 28. 王超, 王智, 孙超, 等. 改良卡槽单钉Scarf截骨术与传统Scarf截骨术治疗足拇外翻畸形效果的比较. 中华解剖与临床杂志, 2023, 28(7): 423-430.
- 29. Basile A, Battaglia A, Campi A. Retrospective analysis of the Ludloff osteotomy for correction of severe hallux valugs deformity. Foot and Ankle Surgery, 2001, 7(1): 1-8.
- 30. Castaneda DA, Myerson MS, Neufeld SK. The Ludloff osteotomy: a review of current concepts. Int Orthop, 2013, 37(9): 1661-1668.
- 31. Robinson AH, Bhatia M, Eaton C, et al. Prospective comparative study of the scarf and Ludloff osteotomies in the treatment of hallux valgus. Foot Ankle Int, 2009, 30(10): 955-963.
- 32. 殷大利, 初娇, 纪祥, 等. 第一跖骨干Scarf截骨结合趾骨Akin截骨治疗中重度踇外翻的短期效果. 精准医学杂志, 2021, 36(6): 541-543.
- 33. Li C, Lu L, Zhang Y, et al. F-Shaped osteotomy combined with basal opening wedge osteotomy for severe hallux valgus. Orthop Surg, 2019, 11(4): 604-612.
- 34. Symeonidis PD, Anderson JG. Original and modified lapidus procedures: proposals for a new terminology. J Bone Joint Surg (Am), 2021, 103(4): e15. doi: 10.2106/JBJS.20.01010.
- 35. Jackson JB, Kennedy B, Deal P, et al. The surgical learning curve for modified lapidus procedure for hallux valgus deformity. Foot Ankle Spec, 2024, 17(1): 9-13.
- 36. Santrock RD, Smith B. Hallux valgus deformity and treatment: A three-dimensional approach: modified technique for lapidus procedure. Foot Ankle Clin 2018, 23(2): 281-295.
- 37. 李大成, 王青松, 宋传航, 等. 改良Lapidus截骨术第1跖楔关节单平面截骨联合第1跖骨下移治疗拇外翻的疗效分析. 生物骨科材料与临床研究, 2024, 21(3): 53-57+63.
- 38. Anderson MR, Ho BS, Baumhauer JF. Republication of "Current concepts review: hallux rigidus". Foot Ankle Orthop 2023, 8(3): 24730114231188123. doi: 10.1177/24730114231188123.
- 39. McGaver RS, Attia AK, Seiffert KJ, et al. Comparative study of staples vs plate and screws for arthrodesis of the first metatarsophalangeal joint. Foot Ankle Orthop 2024, 9(4): 2473011424S00194. doi: 10.1177/2473011424S00194.
- 40. Duff JR, Alecxih AG, White CC, et al. Minimally invasive first metatarsophalangeal joint arthrodesis with a low-profile hybrid locking plate and a beveled compression screw: a surgical technique. Foot Ankle Spec, 2025. doi: 10.1177/19386400251331648.
- 41. Lui TH. Arthroscopic arthrodesis of the first metatarsophalangeal joint in hallux valgus deformity. Arthrosc Tech, 2017, 6(5): e1481-e1487.
- 42. 潘旭月, 王梅青, 陶经纬, 等. 第一跖趾关节融合术与第一跖趾关节置换术治疗进展性踇僵硬的Meta分析. 足踝外科电子杂志, 2020, 7(1): 29-33.
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