Bilateral and Concomitant Pathology' Surgeries Do Not Affect the Outcomes of Mini-Open Distal Linear Metatarsal Osteotomy (bosch Osteotomy) with Manipulation for Hallux Valgus Deformity.

Background: Bosch osteotomy for hallux valgus (HV) deformity has advantages of reduction both the op-erating time and surgical dissection, and may be performed bilaterally and with fewer complications than other surgical procedures as well as early weight-bearing. However, there are few reports on the effects of bilateral simultaneous surgery, simultaneous surgery on concomitant pathologies, and the preoperative HV angle on the postoperative results. The present assessed the factors that might affect the improvement in clinical outcomes following mini-open Bosch osteotomy with manipulation to treat HV deformity. Methods: Seventy patients with 110 feet were included. They were divided into groups as follows: unilateral and bilateral simultaneous surgery groups, Bosch osteotomy alone and simultaneous surgeries for con-comitant pathologies groups, and preoperative HV angle < 40 degrees and >= 40 degrees groups. Subjective clinical out-come scores using the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) and the HV and intermetatarsal first and second metatarsal (M1M2) angles according to the anteroposterior (A-P) view of the weighted foot X-ray were assessed preoperatively and at 12 months after surgery. Results: The mean HV angle, M1M2 angle and all subscales of the SAFE-Q score showed significant im-provement at 12 months after surgery, regardless of simultaneous bilateral surgery, simultaneous surgery for concomitant pathologies, or the preoperative HV angle. On comparing the groups, there were no sig-nificant differences in the HV angle at 12 months after surgery. Significant inferiority at 12 months after surgery was found in the intermetatarsal angle in the simultaneous surgery for concomitant pathologies group and in all subscales of the SAFE-Q score in the HV angle >= 40 degrees group. Conclusion: Mini-open Bosch osteotomy with manipulation for HV deformity demonstrated good results in both radiological assessments and subjective clinical scores at 12 months after surgery, even for simulta-neous bilateral surgery, simultaneous concomitant pathologies' surgery, and severe HV deformity. Level of Evidence: Prognostic Level III, retrospective cohort study. (c) 2022 The Authors. Published by Elsevier Ltd on behalf of European Foot and Ankle Society.