Early Surgical Complication Rates Following Elective Minimally Invasive Surgery Hallux Valgus in Diabetic Patients: A Matched Cohort Analysis

Background: The objective of this study was to assess the types and rates of early complications following elective percutaneous surgery for hallux valgus (HV) in diabetic (DP) vs non-diabetic (NDP) patients. Method: This retrospective study was conducted at our institution between October 2017 and August 2020. During this period, 874 feet underwent percutaneous surgery for HV correction. All adult diabetic patients with controlled diabetes who underwent percutaneous distal metaphyseal osteotomy and had a minimum follow-up of 6 months were included. For each diabetic patient, 2 age-matched (±1 year) non-diabetic controls were randomly selected. Complications were defined as any deviation from the normal postoperative course and were systematically recorded. This work is a retrospective exploratory analysis of a matched cohort. Results: A total of 75 patients were analyzed, 25 DP and 50 NDP, with a mean follow-up of 10.8 months (range 6-48) months. There were no significant differences in demographic characteristics between groups, except for body mass index and Charlson Comorbidity Index, both of which were significantly higher in the DP group ( P < .001 and P = .014, respectively). Although pre- and postoperative functional scale scores did not differ significantly between the groups, the postoperative radiographic angles showed a greater correction in the diabetic group. The overall complication rate was 24% (n = 6) in the DP group and 18% (n = 9) in the NDP group ( P = .553). Complications included infection, osteosynthesis discomfort, pseudarthrosis, residual pain, and metatarsalgia. In the DP group, all superficial infections were successfully managed with oral antibiotics. Conclusion: With the available sample size, no statistically significant differences in the overall complication rate were detected between well-controlled diabetic and non-diabetic patients undergoing minimally invasive hallux valgus surgery. These findings should be interpreted as exploratory and hypothesis-generating, and require confirmation in larger studies.