Resumo

CARVALHO, Paulo et al. Estudo retrospectivo a longo prazo da osteotomia de Reverdin-Isham: limitações e complicações. Rev. Port. Ortop. Traum. [online]. 2017, vol.25, n.4, pp.292-302. ISSN 1646-2122.

Introduction: Percutaneous foot surgery has been gaining greater preponderance in the treatment of foot deformities. The Reverdin-Isham osteotomy is a subcapital first ray osteotomy for the hallux valgus treatment. According to some authors, is indicated in the mild to moderate hallux valgus. There are few published studies on this procedure and none of them with long-term results. The main objective of this study was to evaluate long-term results and eventual limitationsof this technique. Material and Methods: We retrospectively evaluated 25 patients (36 feet) operated on hallux valgus using the Reverdin-Isham operation. Patients with preoperative metatarsalgia, concomitant lateral metatarsal osteotomies and with intermetatarsal angle (IMA) above 17 degrees were excluded. We evaluated, pre and post-operatively, the metatarsophalangeal angle (MPA), IMA and distal metatarsal articular angle (DMAA). We recorded the postoperative AOFAS score, patient satisfaction and eventual complications. Results: Average follow-up was 5.4 years (4.1-7.4 years). The average postoperative AOFAS score was 88.6 (52-100). Thirty three cases (91.7%) were satisfied or very satisfied. The radiographs showed an average correction of 14.6 degrees for the MPA; 2.7 degrees in the IMA and 9.3 degrees for the DMAA. Complications: recurrence of the deformity in 5 cases (13.9%), significant M1 shortening without transfer metatarsalgia in 2 cases (5.5%), 1 case of DMAA overcorrection (2.8%) and 1 case of hypoesthesia (2.8%). There were no cases of loss of passive range of motion superior to 50% of normal or with elevation of the M1 head. Recurrence rate was significantly higher (p = 0.0027) in cases with MPA> 40º. Conclusion: This study shows that the Reverdin-Isham osteotomy is effective in correcting mild to moderate Hallux valgus, even in the long-term. However, there might be a high recurrence rate in cases with an MPA superior to 40 degrees.

Palavras-chave : Hallux valgus; minimally invasive surgery; forefoot deformities; percutaneous surgery; Reverdin-Isham osteotomy.

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