Introduction: We present 34 patients diagnosed with hallux rigidus treated by percutaneous surgery. We analyzed the surgical techniques used and the functional results achieved.

Materials and methods: We retrospectively collected 34 patients (24 women). Patients were stratified by means of parametric x-rays (Hanft classification from 1 to 4). Treatment consisted in a double osteotomy, also known as Keller’s technique, using percutaneous procedures. The postoperative protocol consisted of walking, use of orthopedic footware, and early mobilization.

Results: Mean age was 68.78 years and mean follow-up was 31.45 months. Mean time from first clinical visit to surgery was 4.38 years; most patients had received conservative treatment. The mean degree of hallux rigidus according to the standard classification was 2.5. The mean value of the metacarpophalangeal joint arc and interphalangeal joint arc was 40.35°and 52.14° respectively. Return to work activities was achieved in 90.9%. The mean value according on the VAS (visual analogue scale) (0–10) was 3.14. The mean value on the AOFAS scale was 62.57 (0–100).

Conclusions: Percutaneous surgery is a satisfactory method for the treatment of hallux rigidus, enabling the patient to quickly return to work. This procedure avoids the use of osteosynthesis materials and minimizes the complications seen in open surgery.

Introduction and Objectives: The aim of this report is to present the complications that occur with percutaneous surgery for hallux valgus. Percutaneous surgery is based on a series of combined surgical procedures designed to resolve a deformity.

Materials and Methods: We have reviewed the first 200 cases of percutaneous surgery in our centre. In 136 cases, a diagnosis of hallux valgus was made in association with metatarsalgia and deformity of the toes. There were 40 cases of hallux valgus alone, 24 cases of metatarsal-gias with toe deformities, and 10 cases of toe deformities alone. Patients were treated between February 2001 and February 2002 with a mean follow-up time of 8 months. Complications were analysed clinically and radiographically.

Results: We found the following complications: 4 cases of insufficient bunionectomy, 5 cases of dysesthesia of the first digit, 12 cases of transfer metatarsalgia, 10 cases of asymptomatic metatarsal non-union, 20 cases of superficial infections, 50% of cases with prolonged edema of the foot, and 90% of cases with pain on the dorsum of the foot lasting 3–4 months in cases of meta-tarsalgia. Other less common complications included the following: 1 case of deep vein thrombosis, 1 case of cutaneous necrosis in the area of the anaesthetic block, and 1 case of anterior tibial dysesthesia at the level of the anesthetic block. Repeat treatment was required by 10% of patients.

Discussion and Conclusions: Percutaneous surgery is an alternative to conventional surgery. Advantages included decreased postoperative pain, a rapid return to daily activities, weight-bearing ability in the immediate postoperative period, and the fact that is it a standing surgery. However, it should be remembered that this method is not without its possible complications, which may require repeat treatment.