Advanced Age, Severe Deformity and Diminished Expectations: Functional and Radiological Outcomes of Different Osteotomies for Hallux Valgus in The Elderly
Abstract
Background: Although advanced age is often linked to reduced bone quality in hallux valgus (HV), its direct impact on surgical outcomes is unclear. This study aimed to compare the functional and radiological outcomes of HV surgeries between patients aged ≥65 and <65 years.
Methods: A retrospective analysis of 102 patients who underwent HV surgery between 2011 and 2024 was conducted. Surgical methods included distal and proximal osteotomies and Lapidus arthrodesis. Functional outcomes were assessed using the visual analog scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) Hallux Metatarsophalangeal- Interphalangeal Rating System score. Radiographic outcomes were evaluated using preoperative and postoperative measurements of the hallux valgus angle (HVA) and the intermetatarsal angle (IMA).
Results: Among the 102 patients, 87 were under 65 years of age (85.3%) and 15 were older (14.7%). No significant differences were found between the age groups in terms of AOFAS scores (p=0.916), VAS scores (p=0.481), or radiographic parameters (p>0.05). However, surgical technique significantly affected outcomes; arthrodesis resulted in greater angular correction and lower VAS scores than distal osteotomies (p<0.05). Proximal osteotomies showed better correction than distal procedures, but without significant differences in functional scores (p>0.05).
Conclusions: Age does not significantly affect functional and radiological outcomes in HV surgery. The likelihood of surgical success depends on the technique used rather than the patient’s age. The utilization of individualized treatment plans tailored to the severity of the deformity has been demonstrated to yield superior outcomes, irrespective of the patient's age.
Keywords
Hallux valgus, proximal osteotomy, distal osteotomy, arthrodesis, elderly
Supporting Institution
The authors declared that this study has received no financial support.
Ethical Statement
This study was reviewed and approved by the Marmara University Faculty
of Medicine, Non-Pharmaceuticals and Non-Medical Devices Research
Ethics Committee (Protocol No: 09.2024.1588, Date: 24.12.2024). Informed consent was obtained from all individual participants included in the study.
Thanks
The authors declare that they have no acknowledgements to report.
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