# A Systematic Review of Osteotomies to Correct Hallux Valgus in the First Metastasis
## 4 Discussion
### Analysis of Procedures and Results
By detecting variations in skin temperature, thermography can provide valuable insights into underlying physiological processes, potentially offering a more holistic understanding of treatment outcomes. Moreover, incorporating engineering methodologies presents another promising opportunity to enhance treatment evaluation protocols. For instance, the complete gait load distribution analysis offers a nuanced perspective on how treatment interventions impact biomechanical function. Engineering techniques can facilitate precise measurement and analysis of gait symmetry and load distribution across each limb, thereby enabling a more comprehensive assessment of treatment efficacy. Furthermore, advancements in engineering can contribute to developing specialized tools and technologies tailored to the specific needs of pathology treatment evaluation. By leveraging engineering expertise, innovative solutions can be devised to address existing limitations and enhance the accuracy and reliability of treatment assessment methodologies. In conclusion, while traditional evaluation approaches have their merits, there is a growing recognition of the need for more sophisticated and comprehensive assessment methods in pathology treatment. Incorporating techniques such as thermographic analysis and engineering-based approaches holds significant promise in enriching our understanding of treatment outcomes and ultimately improving patient care. Most studies compare pre- and post-surgical hallux deformation and analyze patient satisfaction and pain level; however, some focus on plantar pressure. After analyzing the results based on plantar pressure distribution on the foot, we identified the evaluation models, fixed platforms, and plantar pressure insoles. The platforms offer high-resolution measurements and are accurate, but they run the risk of providing unreliable information, as walking can change without apparent patient awareness. It is possible to carry out static and dynamic measurements and have the platform directly in contact with the skin of the foot. Tests are carried out barefoot, while insoles are used in dynamic studies. Furthermore, insoles generally allow for more reliable and precise measurements of plantar pressure centers. This is because contact with the foot is much more organic, with the disadvantage of requiring more care due to slipping that can occur inside the shoe, as well as foot perspiration that can compromise the sensors. Thus, it is an analysis process that requires more care and can be more expensive as the insole has to be personalized, but it is more reliable if used well. This can be concluded by understanding the use of reported studies of four fixed platforms and one with plantar pressure insoles. By analyzing the values of peak pressures, we were able to analyze the tables and see that there are no discrepancies that the authors consider significant in the foot's structure. They unanimously consider that the procedures provide quality of life to patients due to the foot's aesthetics and shape and because they no longer feel pain. However, once altered, the foot's structure does not change significantly after the surgical procedure. It is concluded that the minor the procedure in terms of incision in the bone, the better. In summary, all procedures are viable, but considering the balance between optimal results, lower risks of errors, and smaller incisions, basal closing wedge osteotomy and distal Chevron osteotomy are recommended. Focusing on the fact that this is a systematic review article, the content presented corresponds only to what the articles primarily present. A more significant explanation of some procedures in some articles and discrepancies in biomechanical studies would be advantageous, allowing a critical approach to the advantages and disadvantages of each approach, as well as their restrictions and contraindications.