Growth Modulation for the Treatment of Juvenile Hallux Valgus: A Systematic Review of Literature

Muadh AlZeedi; J Patrick Park; Yousef Marwan; Khaled Mousa Abu-Dalu; Reggie Hamdy; Chantal Janelle

doi:10.5005/jp-journals-10080-1579

Growth Modulation for the Treatment of Juvenile Hallux Valgus: A Systematic Review of Literature

Strategies Trauma Limb Reconstr. 2023 Jan-Apr;18(1):51-55. doi: 10.5005/jp-journals-10080-1579.

Authors

Muadh AlZeedi¹, J Patrick Park¹, Yousef Marwan², Khaled Mousa Abu-Dalu¹, Reggie Hamdy¹, Chantal Janelle¹

Affiliations

¹ Department of Pediatric Orthopaedic Surgery, Shriners Hospital for Children; Division of Pediatric Orthopaedic Surgery, Department of Pediatric Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
² Department of Surgery, College of Medicine, Health Sciences Centre, Kuwait University, Kuwait City, Kuwait.

Abstract

Background: Juvenile hallux valgus (JHV) is a forefoot deformity that causes pain and functional limitation. Treatment poses a challenge in terms of the optimal technique and timing of intervention. A systematic review of the literature on the use of growth modulation in treating JHV was conducted.

Materials and methods: The literature review was performed using PubMed and EMBASE searches for articles investigating growth modulation in the treatment of JHV published before December 1st, 2021. Seven articles were included in the final review that matched the inclusion and exclusion criteria. The primary outcomes included the degree of correction of hallux valgus angle and intermetatarsal angle. A qualitative assessment of the articles was done due to the heterogeneity of the growth modulation methods used in these articles.

Results: A total of 135 feet from 78 patients were included from the reviewed articles. Growth modulation methods included temporary screw lateral hemiepiphysiodesis of the first metatarsal, lateral drilling hemiepiphysiodesis of the first metatarsal, and a trephine plug removal of the lateral epiphysis followed by cancellous bone graft insertion. The degree of correction of the hallux valgus and intermetatarsal angles were found to be statistically significant in all studies, regardless of the technique.

Conclusion: Growth modulation for JHV by lateral hemiepiphysiodesis using minimally invasive techniques produced favourable radiologic outcomes with some evidence of clinical improvement. Larger, prospective and comparative studies with objective clinical outcome measures may further consolidate this surgical approach as a mean to treating this deformity.

How to cite this article: AlZeedi M, Park JP, Marwan Y, et al. Growth Modulation for the Treatment of Juvenile Hallux Valgus: A Systematic Review of Literature. Strategies Trauma Limb Reconstr 2023;18(1):51-55.

Keywords: Epiphysiodesis; Growth modulation; Hemiepiphysiodesis; Juvenile hallux valgus; Paediatric hallux valgus.

Publication types

Review