Percutaneous vs Open Surgery for Hallux Valgus Correction: A Meta Analysis

Background: Hallux valgus is a common forefoot deformity often corrected through either open or minimally invasive surgery (MIS). MIS has gained popularity due to its potential benefits, including reduced tissue trauma and quicker recovery. However, the comparative effectiveness of MIS versus open surgery remains unclear. Objective: To compare clinical outcomes between percutaneous (MIS) and open surgical techniques for hallux valgus correction. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. Databases searched included PubMed, ProQuest, and Google Scholar for studies published between January 2007 and March 2022. Inclusion criteria were studies comparing MIS with open surgery and reporting at least one of the following outcomes: AOFAS score, VAS score, complication rate, or length of hospitalization. Data were analyzed using RevMan 5.4 and R software. Results: Six studies involving 472 feet (214 MIS, 258 open surgery) met the criteria. No significant differences were found in AOFAS scores preoperatively (MD = 0.95; p = 0.50) or postoperatively (MD = 0.00; p = 0.34). Postoperative VAS scores favored MIS (MD = -0.93; p < 0.05), indicating lower pain levels. Complication rates were significantly higher in the open surgery group (RR = 1.56; p < 0.05), and length of hospitalization was shorter in the MIS group (MD = -0.66; p < 0.05). Conclusion: MIS provides similar functional outcomes to open surgery but results in lower postoperative pain, fewer complications, and shorter hospital stays. These findings support MIS as a safe and effective alternative for hallux valgus correction.