Minimally invasive percutaneous surgical techniques with internal fixation for correcting hallux valgus

NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 11 sources, which was discussed by the committee. The evidence included 2 systematic reviews and meta-analyses, 3 randomised controlled trials, 3 retrospective cohort studies (1 with propensity score matching) and 3 case series. It is presented in the summary of key evidence section in the interventional procedures overview. Other relevant literature is listed in table 5 of the overview.

The professional experts and the committee considered the key efficacy outcomes to be: patient-reported outcome measures such as reduction in pain, improvement in function, quality of life and patient satisfaction; hallux joint angle correction and maintenance or reduction in deformity; and recurrence rate.

The professional experts and the committee considered the key safety outcomes to be: pain, skin irritation, infection, non-union, need for screw removal, reoperation and amputation.

One commentary from a person who has had this procedure was discussed by the committee.

Despite minimally invasive surgery, there is no evidence that osteotomy heals more quickly than standard open surgical procedures.

Although the surgery is minimally invasive, pain in recovery did not appear to be different in the longer term compared with open surgical procedures.

People having the procedure should be informed about the potential for implant removal and recovery time.