Outcomes of the modified McBride procedure for hallux valgus: analysis of the radiographic measurements

INTRODUCTION: The current study aimed to analyze both the modified McBride procedure's radiographic outcomes and the relationships between radiographic measurements after this technique.
METHODS: Forty-five feet of 42 patients who underwent isolated modified McBride procedure were included in the study. Preoperative and postoperative radiographic measurements, including hallux valgus angle (HVA), intermetatarsal angle (IMA), tibial sesamoid position (TSP), and fibular sesamoid distance (FSD) to second metatarsal, as well as their relationships were assessed. Postoperative pain was evaluated using the visual analog scale (VAS).
RESULTS: Mean age of the patients was 44.6±16.8 (range, 17-78) years, and the mean follow-up period was 42.4±9 (range, 25-59) months. Postoperatively, mean HVA, IMA, and TSP significantly decreased from 37.4° to 14.9°, from 15.1° to 11.5°, and from 2.2 to 1.1, respectively (p<0.01). FSD did not change significantly (p=0.47). Recurrence of the deformity was observed in 23 feet. Feet with HVA>35° did not have a higher recurrence rate than feet with HVA<35° (p=0.15). VAS was not significantly different in recurrent and non-recurrent feet (p=0.69). While TSP correction was significantly reduced in feet with preoperative IMA>15°, FSD correction was significantly higher in feet with HVA correction >20° (p<0.01 for both).
DISCUSSION AND CONCLUSION: Modified McBride was sufficient for reducing the HVA, IMA, and TSP but did not influence FSD. Recurrence was observed in more than half of the feet, but having a preoperative HVA>35° was not associated with higher recurrence rates, as well as worse pain. Further studies may be needed better to understand the complicated relationship between angular measurements and sesamoids.