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Bösch osteotomy for hallux valgus correction: results at a mean 10-year follow-up

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Bösch osteotomy (BO), which is a first metatarsal subcapital osteotomy stabilised with a K-wire, is a surgical option to correct hallux valgus (HV). The aim of this study was to assess the long-term clinical and radiographic results in a cohort of patients treated at our institution with such osteotomy.

Methods

In this retrospective monocentric single-surgeon cohort study, we included 58 HVs (46 patients) who underwent HV correction by BO and were followed at a minimum of 7 years. The range of motion (ROM), the American Orthopaedic Foot and Ankle Society’s Forefoot scale (AOFAS-FS) and the Visual Analogic Scale (VAS) for pain were recorded. On weightbearing radiographs, the Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), the Distal Metatarsal Articular Angle (DMAA), and the Lateral Sesamoid Position (LSP) were measured and compared with pre-operative values. The complication rate and first metatarsophalangeal joint stiffness were also assessed.

Results

At a mean follow-up of 10 ± 2 (7–17) years, mean ± standard deviation AOFAS-FS and VAS were 89 ± 11 (67–93) and 2.1 ± 2.8 (0–7) points, respectively. In 42 (72%) cases there was no limitation in the choice of footwears. Radiographically, we found a significant improvement in the HVA (from 33.9° ± 6.7 to 18.8° ± 5.6, p < 0.001), in the IMA (14.2° ± 3.1 to 9.4° ± 2.7, p < 0.001), in the DMAA (from 30.3° ± 6.8 to 11.5° ± 5.1, p < 0.001) and in LSP (median value from 3 to 1, p < 0.001). In 36 (62%) cases the ROM was greater than 75° while in 22 (38%) it ranged between 30° and 75°. Minor complications occurred in six (10%) cases, which did not require any further surgery at the longest follow-up.

Conclusion

Bösch technique provided satisfactory clinical and radiographic outcomes in the treatment of hallux valgus which persisted at a mean 10-year follow-up. The complication rate did not differ from more recent techniques described in literature.

Level of evidence

Level IV, retrospective cohort study.

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Funding

No funding was received for the present study.

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Authors and Affiliations

  1. Orthopaedic and Traumatology Unit, Department of Public Health, University “Federico II” of Naples, Naples, Italy

    Alessio Bernasconi, Maria Rizzo, Antonio Izzo, Salvatore Vallefuoco, Anna Paola Russo, Valentina Rossi, Biagio Abate, Amedeo Guarino & Massimo Mariconda

Authors
  1. Alessio Bernasconi
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  2. Maria Rizzo
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  3. Antonio Izzo
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  4. Salvatore Vallefuoco
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  5. Anna Paola Russo
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  6. Valentina Rossi
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  7. Biagio Abate
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  8. Amedeo Guarino
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  9. Massimo Mariconda
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Contributions

AB: study design, statistical analysis, interpretation of results, revision of the paper, supervision of the whole study. MR: study design, collection of data, interpretation of results, revision of the paper. AI: collection of data, interpretation of results, revision of the paper. SV: collection of data, interpretation of results, revision of the paper. APR: collection of data, interpretation of results, revision of the paper. VR: collection of data, interpretation of results, revision of the paper. BA: collection of data, interpretation of results, revision of the paper. AG: collection of data, interpretation of results, revision of the paper. MM: study design, statistical analysis, interpretation of results, revision of the paper, supervision of the whole study.

Corresponding author

Correspondence to Alessio Bernasconi.

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The study was approved by the local institute relevant Review Board.

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All patients involved were informed about the study and provided a formal consent to be part of it.

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Bernasconi, A., Rizzo, M., Izzo, A. et al. Bösch osteotomy for hallux valgus correction: results at a mean 10-year follow-up. Arch Orthop Trauma Surg 143, 1293–1300 (2023). https://doi.org/10.1007/s00402-021-04259-3

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  • DOI: https://doi.org/10.1007/s00402-021-04259-3

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