Current evidence on the efficacy of surgical correction of hallux valgus using minimal access techniques is limited and inconsistent. In addition, the evidence relates to a range of different surgical techniques. The evidence on safety is inadequate. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research.
Clinicians wishing to undertake surgical correction of hallux valgus using minimal access techniques should take the following actions.
Inform the clinical governance leads in their Trusts.
Ensure that patients and their carers understand the uncertainty about the procedure's safety and efficacy and provide them with clear written information. In addition, the use of the information for the public is recommended.
Audit and review clinical outcomes of all patients having surgical correction of hallux valgus using minimal access techniques (see section 3.1).
Further research should evaluate clearly described minimal access procedures using well-defined modern forms of osteotomy. Both objective and functional outcome measures should be reported, together with measurements of pain relief and patient satisfaction, including cosmesis. All adverse events should be described.
NICE may review this procedure on publication of further evidence.