The Endolog technique for moderate to severe hallux valgus treatment: Clinical and radiographic analysis of 194 patients

•Endolog technique for hallux valgus treatment is characterized by little skin incision and soft tissues sparing.•This study investigates the clinical and radiographic potential of the Endolog technique on the correction of moderate and severe HV deformity.•194 feet underwent HV correction respecting study’s criteria and all clinical cases were evaluated through HVA, IMA, PASA and AOFAS scores.•6 cases of complications were detected during 2-years’ follow-up: 4 cases of HV recurrence and 2 cases of irritative device-related pain.•Clinical and radiographic results, as well as patient satisfaction, were comparable with other surgical techniques described in literature. Endolog is an intra-medullary titanium device used for a minimally-invasive hallux valgus correction. The aim of this study was to evaluate clinical and radiographic outcomes of this device. A retrospective study with a prospective data collection was conducted. Patients underwent to Endolog procedures from September 2009 to April 2017 were enrolled. Mild HV deformity (HVA ≤ 19° and IMA ≤ 13°) or associated procedure to Endolog technique were excluded. The radiological (HVA, IMA and PASA) and clinical (AOFAS score) pre and post-operative data were compared through Wilcoxon Signed-Rank test. 194 feet (144 moderate and 50 severe HV) underwent HV correction respecting study’s criteria. AOFAS scores significantly improved from 31.0 ± 12.7 points preoperatively to 88.5 ± 8.0 at 24 months. Even all radiographic measurements significantly improved during 2 years’ follow-up. Only 6 patients experienced complications: 4 cases of HV recurrence and 2 cases of intolerance device-related pain. Endolog technique proved to be a valid option in the moderate-to-severe hallux valgus treatment, comparable to other surgical techniques described in literature.