Correction of hallux valgus through minimally invasive percutaneous techniques: the WOS procedure. Long-term efficacy and application across different age groups

BACKGROUND: Hallux valgus (HV), characterized by lateral deviation of the big toe, presents a significant orthopedic challenge. The “without osteosynthesis” (WOS) technique, a minimally invasive percutaneous approach, has been proposed as an effective treatment option. This study assesses the efficacy and safety of the WOS technique in a four-year follow-up of 260 patients, derived from an initial cohort of 642, categorized by age. METHODS: Key parameters including the hallux valgus angle (HVA), intermetatarsal angle (IMA), range of motion (ROM) of the big toe, and the American Orthopedic Foot and Ankle Society (AOFAS) score were evaluated at baseline, six months (T1), and four years (T2) after surgery. Patients were divided into five age-based groups for analysis. Statistical evaluations involved paired t-tests for pre and postoperative comparisons at T1 and T2, and one-way ANOVA for age-related analysis, supplemented by Tukey's post-hoc analysis. RESULTS: Significant improvements were observed in HVA, IMA, ROM, and AOFAS scores at both T1 and T2 across all age groups, demonstrating the effectiveness of the WOS technique. Notably, patients aged 60 to 80 years showed a reduction in ROM, suggesting age-specific considerations are necessary. Complications were minimal, highlighting the safety of the procedure. CONCLUSIONS: The WOS technique offers a promising solution for HV treatment, ensuring long-term benefits in deformity correction, patient satisfaction, and pain reduction. Despite its efficacy, further research is recommended to optimize outcomes, particularly for elderly patients, thereby enhancing functional benefits and minimizing complications.