First web space soft tissue release in bunion surgery: functional outcomes of a new technique.

BACKGROUND: The current approach to soft tissue release in bunion surgery is through an incision in the dorsum of the first web space between the first and second metatarsals. However, the soft tissue release through this approach can be excessive or inadequate for the correction required. In addition, it leaves a visible scar. A new technique described here provides a stepwise protocol to limit the extent of soft tissue release to only what is required for the correction. The purpose of this study was to evaluate functional outcomes of the new technique.

MATERIALS AND METHODS: The authors conducted a retrospective chart review of 76 patients (88 procedures) and functional outcome analysis of 38 patients (44 procedures) who underwent first web space release utilizing the new technique. The mean followup was 3.8 years. The mean age was 50.8 (range, 24 to 74) years; 98% were female patients and 2% were male.

RESULTS: The majority of the patients (89%) had good or excellent results. The surgical scar was hidden between the first and second toes in the web fold. The average Olerud-Molander score was 86.4 out of 100. None of the patients reviewed had nerve injury, recurrence of deformity, hallux varus, or revision surgery.

CONCLUSION: The new technique for the first web space soft tissue release was a reliable technique that can be used as an adjunctive surgical procedure in correction of hallux valgus. Since the incision is in the web fold, the resulting scar is hidden.