Incidence and Risk Factors for Short-Term Reoperations After Open First-Metatarsal Osteotomy for Hallux Valgus

Background: Despite the satisfactory results of hallux valgus surgery in general, the incidence of complications has been considerably high. This study evaluated the incidence and risk factors of short-term reoperations after surgical correction of hallux valgus deformity with first metatarsal osteo...

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Main Authors: Tuuli Erjanti MD, Heli Keskinen MD, PhD, Tiia Rissanen MSc, Keijo Mäkelä MD, PhD, Petteri Lankinen MD, PhD, Inari Laaksonen MD, PhD, Helka Koivu MD, PhD
Format: Article
Language:English
Published: SAGE Publishing 2025-08-01
Series:Foot & Ankle Orthopaedics
Online Access:https://doi.org/10.1177/24730114251359646
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author Tuuli Erjanti MD
Heli Keskinen MD, PhD
Tiia Rissanen MSc
Keijo Mäkelä MD, PhD
Petteri Lankinen MD, PhD
Inari Laaksonen MD, PhD
Helka Koivu MD, PhD
author_facet Tuuli Erjanti MD
Heli Keskinen MD, PhD
Tiia Rissanen MSc
Keijo Mäkelä MD, PhD
Petteri Lankinen MD, PhD
Inari Laaksonen MD, PhD
Helka Koivu MD, PhD
author_sort Tuuli Erjanti MD
collection DOAJ
description Background: Despite the satisfactory results of hallux valgus surgery in general, the incidence of complications has been considerably high. This study evaluated the incidence and risk factors of short-term reoperations after surgical correction of hallux valgus deformity with first metatarsal osteotomy. Methods: We conducted a retrospective review of 685 consecutive open first-metatarsal osteotomies performed from 2013 to 2018 in a single university-hospital region. The number, indications, and type of reoperation were collected. The association between reoperation and patient’s age, sex, BMI, comorbidities, preoperative hallux valgus angle (HVA), hospital type, osteotomy type, and surgeon’s experience was analyzed. Results: There were 79 reoperations (11.5%) at a median of 14 months (range, 1-83) postoperatively. Fifteen reoperations were merely hardware removals. Most reoperations (46%) were performed because of residual deformity. Preoperative and postoperative HVA, diabetes, and type of osteotomy were statistically significant risk factors for all-cause reoperation both in univariate ( P  < .0001, P  = .0052, and P  < .0001, respectively) and multivariate analysis ( P  < .0001, P  = .0059, and P  < .0001, respectively). Overall, 4.9% of distal, 18.7% of midshaft, and 29.3% of proximal osteotomies were reoperated. Conclusion: The incidence of short-term (≤24-month) reoperations was higher than previously reported after open surgical correction of hallux valgus deformity with first metatarsal osteotomy. Larger preoperative and postoperative HVA, diabetes, and type of osteotomy were associated with revision surgery in this retrospective cohort. Proximal osteotomies had the highest risk for reoperation. Level of Evidence: Level IV, case series.
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spelling doaj-art-d48454de7dcd4c48b7b371be951f14f92025-08-22T20:03:41ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142025-08-011010.1177/24730114251359646Incidence and Risk Factors for Short-Term Reoperations After Open First-Metatarsal Osteotomy for Hallux ValgusTuuli Erjanti MD0Heli Keskinen MD, PhD1Tiia Rissanen MSc2Keijo Mäkelä MD, PhD3Petteri Lankinen MD, PhD4Inari Laaksonen MD, PhD5Helka Koivu MD, PhD6Department of Orthopaedics and Traumatology, Turku University Hospital and University of Turku, Turku, FinlandDepartment of Pediatric Surgery and Orthopaedics, Turku University Hospital, Turku, FinlandDepartment of Biostatistics, University of Turku and Turku University Hospital, Turku, FinlandDepartment of Orthopaedics and Traumatology, Turku University Hospital and University of Turku, Turku, FinlandDepartment of Orthopaedics and Traumatology, Turku University Hospital and University of Turku, Turku, FinlandDepartment of Orthopaedics and Traumatology, Turku University Hospital and University of Turku, Turku, FinlandHospital Pihlajalinna Turku, Turku, FinlandBackground: Despite the satisfactory results of hallux valgus surgery in general, the incidence of complications has been considerably high. This study evaluated the incidence and risk factors of short-term reoperations after surgical correction of hallux valgus deformity with first metatarsal osteotomy. Methods: We conducted a retrospective review of 685 consecutive open first-metatarsal osteotomies performed from 2013 to 2018 in a single university-hospital region. The number, indications, and type of reoperation were collected. The association between reoperation and patient’s age, sex, BMI, comorbidities, preoperative hallux valgus angle (HVA), hospital type, osteotomy type, and surgeon’s experience was analyzed. Results: There were 79 reoperations (11.5%) at a median of 14 months (range, 1-83) postoperatively. Fifteen reoperations were merely hardware removals. Most reoperations (46%) were performed because of residual deformity. Preoperative and postoperative HVA, diabetes, and type of osteotomy were statistically significant risk factors for all-cause reoperation both in univariate ( P  < .0001, P  = .0052, and P  < .0001, respectively) and multivariate analysis ( P  < .0001, P  = .0059, and P  < .0001, respectively). Overall, 4.9% of distal, 18.7% of midshaft, and 29.3% of proximal osteotomies were reoperated. Conclusion: The incidence of short-term (≤24-month) reoperations was higher than previously reported after open surgical correction of hallux valgus deformity with first metatarsal osteotomy. Larger preoperative and postoperative HVA, diabetes, and type of osteotomy were associated with revision surgery in this retrospective cohort. Proximal osteotomies had the highest risk for reoperation. Level of Evidence: Level IV, case series.https://doi.org/10.1177/24730114251359646
spellingShingle Tuuli Erjanti MD
Heli Keskinen MD, PhD
Tiia Rissanen MSc
Keijo Mäkelä MD, PhD
Petteri Lankinen MD, PhD
Inari Laaksonen MD, PhD
Helka Koivu MD, PhD
Incidence and Risk Factors for Short-Term Reoperations After Open First-Metatarsal Osteotomy for Hallux Valgus
Foot & Ankle Orthopaedics
title Incidence and Risk Factors for Short-Term Reoperations After Open First-Metatarsal Osteotomy for Hallux Valgus
title_full Incidence and Risk Factors for Short-Term Reoperations After Open First-Metatarsal Osteotomy for Hallux Valgus
title_fullStr Incidence and Risk Factors for Short-Term Reoperations After Open First-Metatarsal Osteotomy for Hallux Valgus
title_full_unstemmed Incidence and Risk Factors for Short-Term Reoperations After Open First-Metatarsal Osteotomy for Hallux Valgus
title_short Incidence and Risk Factors for Short-Term Reoperations After Open First-Metatarsal Osteotomy for Hallux Valgus
title_sort incidence and risk factors for short term reoperations after open first metatarsal osteotomy for hallux valgus
url https://doi.org/10.1177/24730114251359646
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