Clinical Practice Guideline on the Diagnosis and Treatment of Hallux Valgus

Abstract

Hallux Valgus (HV) is a condition with high prevalence in the general population that can cause important consequences in terms of pain and limitation in activities of daily living. Besides, HV surgery is a frequent surgical procedure that impose significant surgical and medical costs including implants, hospital expenses, used drugs and period of sick leave, in addition to the increased overall costs that could involve its poor management. The management of this pathology is barely unified in the current literature whilst there are many and varied surgical techniques (more than 100 described), the indications of which overlaps in many cases, leaving unclear as to what is the best approach to the treatment of this problem globally. In addition, there is no level 1 evidence available to prove which is the best option for each particular patient. It is therefore necessary to create standard format to be adopted in each clinical scenario and set out the standards to guide that process. This article aims to propose a clinical practice guideline that covers all types of HV in the population as a whole and that can be used systematically in each case. A flow chart is detailed with the preference of the surgical technique on a case-by-case basis and a clinical pathway is drawn on the management of this condition including all professionals involved from the first assessment to the final discharge.