Evaluation of K-wires splinting of first and second metatarsals following proximal open wedge osteotomy for hallux valgus correction

Abstract

Background: Hallux valgus is a prevalent foot deformity affecting a significant portion of the population and often managed through various surgical techniques. Proximal opening wedge osteotomy of the first metatarsal bone is a popular and effective management modality, yet there remains no consensus on the optimal fixation method PURPOSE: Evaluating the outcomes of K-wires fixation versus plate and screws fixation following proximal opening wedge osteotomy of the first metatarsal bone for managing moderate to severe hallux valgus STUDY DESIGN: Retrospective multicenter cohort study.

Methods: Forty patients were evenly divided into two groups; Group A (K-wires fixation to the second metatarsal) and Group B (plate and screws fixation). Patients were followed up for at least 1 year.

Results: Both groups showed significant improvements in hallux valgus angle, inter-metatarsal angle, and American Orthopedic Foot and Ankle Society scores, with no significant differences between them. However, K-wires fixation was associated with lower implant costs (P = 0.01), and fewer subsequent surgeries (P = 0.01). Complications such as complex regional pain syndrome and wound issues were more frequent in the plate group, with six cases requiring plate removal due to prominence CONCLUSION: K-wire fixation is a cost-effective and reliable alternative to plate and screws fixation, offering similar clinical outcomes while reducing secondary surgical intervention rates.

Keywords: Cost effectiveness in foot surgery; First metatarsal bone osteotomy; Hallux valgus angle; Inter-metatarsal angle; K-wires metatarsal splinting; Open wedge osteotomy; Percutaneous osteotomy.