Long-term follow-up of hallux valgus surgery in patients with down's syndrome: a case series.

Abstract

The aim of our study is to describe the long-term radiological and functional results of hallux valgus (HV) surgery in a series of adult patients with Down syndrome (DS). As far as we know, no other studies have been published regarding this topic. A retrospective study was conducted on a case series of patients with DS who underwent surgery for HV at our institution with a minimum follow-up of 2 years. Pre- and postoperative radiological outcomes (HVA and IMA); functional outcomes using the American Orthopaedic Foot and Ankle Society-MetaTarsoPhalangeal-InterPhalangeal Scale (AOFAS-MTP-IP); health-related quality of life outcomes using the Manchester-Oxford Foot Questionnaire (MOXFQ) and the EuroQol Five Dimensions tool (EQ-5D-5L); pain using the Visual Analogue Scale (VAS) and complication and reoperation rates were assessed. The study included seven patients (9 feet). The median age at surgery was 39 (range 27-41.5) years, and the median follow-up was 10.7 (range 3.7-15.2) years. One year after surgery, there was a statistically significant improvement in radiological outcomes, with a median HVA and IMA correction of 12.5 (11.3-22.5) and 12.0 (11.4-17.7) degrees, respectively, and a correction loss of 3.9 (0.8-6.9) and 0.6 (0.2-1.1) degrees at the end of follow-up. The median AOFAS-MTP-IP scale score was 71.0 points (63.0-78.5). The median global MOXFQ score was 28.1 (7.8-43.7). During follow-up, four patients required surgical revision. At the end of follow-up, the median VAS score was 0 (0-4) and only one patient had problems with footwear. Surgical treatment of HV in patients with DS provides acceptable radiological results with excellent functional outcomes, although a high rate of reoperation has been observed.