A modified minimally invasive osteotomy for hallux valgus enables reduction of malpositioned sesamoid bones.
Distal metatarsal osteotomy
Hallux valgus
Metatarsal sesamoid bones
Minimally invasive chevron and akin
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
17
06
2022
accepted:
26
03
2023
medline:
11
9
2023
pubmed:
19
5
2023
entrez:
18
5
2023
Statut:
ppublish
Résumé
The current minimally invasive distal metatarsal osteotomy for hallux valgus (HV) is V-shaped, which prevents the correction of the rotational metatarsal head deformity and reduction of the sesamoid bones. We sought to determine the optimal method for sesamoid bone reduction during HV surgery. We reviewed the medical records of 53 patients who underwent HV surgery between 2017 and 2019 using one of three techniques: open chevron osteotomy (n = 19), minimally invasive V-shaped osteotomy (n = 18), and a modified straight minimally invasive osteotomy (n = 16). The sesamoid position was graded using the Hardy and Clapham method on weight-bearing radiographs. When compared to open chevron and V-shaped osteotomies, the modified osteotomy resulted in significantly lower postoperative sesamoid position scores (3.74 ± 1.48, 4.61 ± 1.09, and 1.44 ± 0.81, respectively, P < 0.001). Furthermore, the mean change in postoperative sesamoid position score was greater (P < 0.001). The modified minimally invasive osteotomy was superior to the other two techniques in correcting HV deformity in all planes, including sesamoid reduction.
Sections du résumé
BACKGROUND
BACKGROUND
The current minimally invasive distal metatarsal osteotomy for hallux valgus (HV) is V-shaped, which prevents the correction of the rotational metatarsal head deformity and reduction of the sesamoid bones. We sought to determine the optimal method for sesamoid bone reduction during HV surgery.
METHODS
METHODS
We reviewed the medical records of 53 patients who underwent HV surgery between 2017 and 2019 using one of three techniques: open chevron osteotomy (n = 19), minimally invasive V-shaped osteotomy (n = 18), and a modified straight minimally invasive osteotomy (n = 16). The sesamoid position was graded using the Hardy and Clapham method on weight-bearing radiographs.
RESULTS
RESULTS
When compared to open chevron and V-shaped osteotomies, the modified osteotomy resulted in significantly lower postoperative sesamoid position scores (3.74 ± 1.48, 4.61 ± 1.09, and 1.44 ± 0.81, respectively, P < 0.001). Furthermore, the mean change in postoperative sesamoid position score was greater (P < 0.001).
CONCLUSION
CONCLUSIONS
The modified minimally invasive osteotomy was superior to the other two techniques in correcting HV deformity in all planes, including sesamoid reduction.
Identifiants
pubmed: 37202550
doi: 10.1007/s00402-023-04868-0
pii: 10.1007/s00402-023-04868-0
doi:
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
6105-6112Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
De Prado M (2011) Minimally invasive foot surgery: a paradigm shift. Minimally invasive surgery of the foot and ankle. Springer, London, pp 3–11
Ferrari J, Higgins JPT, Prior TD (2004) Interventions for treating hallux valgus (abducto valgus) and bunions. Cochrane Database Syst Rev 1:CD000964
Fraissler L, Konrads C, Hoberg M, Rudert M, Walcher M (2016) Treatment of hallux valgus deformity. EFORT Open Rev Br Editor Soc Bone Jt Surg 1:295–302
Knoth C, Carow L, Zettl R, Welter JE, Hess F (2016) Short- and long-term outcomes following hallux-valgus correction: a modified Kramer osteotomy. Arch Orthop Trauma Surg 136:1349–1355. https://doi.org/10.1007/s00402-016-2531-8
doi: 10.1007/s00402-016-2531-8
pubmed: 27475641
Palmanovich E, Myerson MS (2014) Correction of moderate and severe hallux valgus deformity with a distal metatarsal osteotomy using an intramedullary plate. Foot Ankle Clin 19(2):191–201
doi: 10.1016/j.fcl.2014.02.003
pubmed: 24878409
Ji L, Wang K, Ding S, Sun C, Sun S, Zhang M (2022) Minimally invasive vs. open surgery for hallux valgus: a meta-analysis. Front Surg 9:843410
doi: 10.3389/fsurg.2022.843410
pubmed: 35388365
pmcid: 8978717
Lewis TL, Ray R, Miller G, Gordon DJ (2021) Third-generation minimally invasive chevron and akin osteotomies (MICA) in hallux valgus surgery: two-year follow-up of 292 cases. J Bone Jt Surg Am 103:1203
doi: 10.2106/JBJS.20.01178
Lu J, Zhao H, Liang X, Ma Q (2020) Comparison of minimally invasive and traditionally open surgeries in correction of hallux valgus: a meta-analysis. J Foot Ankle Surg 59:801–806
doi: 10.1053/j.jfas.2019.03.021
pubmed: 32600562
Kaufmann G, Dammerer D, Heyenbrock F, Braito M, Moertlbauer L, Liebensteiner M (2019) Minimally invasive versus open chevron osteotomy for hallux valgus correction: a randomized controlled trial. Int Orthop 43:343
doi: 10.1007/s00264-018-4006-8
pubmed: 29869014
Bernasconi A, Rizzo M, Izzo A, Vallefuoco S, Russo AP, Rossi V et al (2021) Bösch osteotomy for hallux valgus correction: results at a mean 10-year follow-up. Arch Orthop Trauma Surg 143:1293–300. https://doi.org/10.1007/s00402-021-04259-3
doi: 10.1007/s00402-021-04259-3
pubmed: 34839385
Izzo A, Vallefuoco S, Basso MA, Ray R, Smeraglia F, Cozzolino A et al (2022) Role of lateral soft tissue release in percutaneous hallux valgus surgery: a systematic review and meta-analysis of the literature. Arch Orthop Trauma Surg 1:1–11. https://doi.org/10.1007/s00402-022-04693-x
doi: 10.1007/s00402-022-04693-x
Harrasser N, Hinterwimmer F, Baumbach SF, Pfahl K, Glowalla C, Walther M et al (2022) The distal metatarsal screw is not always necessary in third-generation MICA: a case–control study. Arch Orthop Trauma Surg 1:1–7. https://doi.org/10.1007/s00402-022-04740-7
doi: 10.1007/s00402-022-04740-7
Maffulli N, Longo UG, Marinozzi A, Denaro V (2011) Hallux valgus: effectiveness and safety of minimally invasive surgery. A systematic review. Br Med Bull 97:149–167
doi: 10.1093/bmb/ldq027
pubmed: 20710024
Giannini S, Bevoni R, Vannini F, Cadossi M (2010) Hallux valgus surgery: the minimally invasive bunion correction. Minimally invasive surgery in orthopedics. Springer, New York, pp 463–471
doi: 10.1007/978-0-387-76608-9_56
Magnan B, Pezzè L, Rossi N, Bartolozzi P (2005) Percutaneous distal metatarsal osteotomy for correction of hallux valgus. J Bone Jt Surg-Ser A 87:1191–1199
Malagelada F, Sahirad C, Dalmau-Pastor M, Vega J, Bhumbra R, Manzanares-Céspedes MC et al (2019) Minimally invasive surgery for hallux valgus: a systematic review of current surgical techniques. Int Orthop 43:625–37
doi: 10.1007/s00264-018-4138-x
pubmed: 30218181
Vernois J, Redfern DJ (2016) Percutaneous surgery for severe hallux valgus. Foot Ankle Clin 21:479–93
doi: 10.1016/j.fcl.2016.04.002
pubmed: 27524702
Deenik AR, De Visser E, Louwerens JWK, Malefijt MDW, Draijer FF, De Bie RA (2008) Hallux valgus angle as main predictor for correction of hallux valgus. BMC Musculoskelet Disord 9:1–6
doi: 10.1186/1471-2474-9-70
Okuda R, Kinoshita M, Yasuda T, Jotoku T, Shima H, Takamura M (2011) Hallux valgus angle as a predictor of recurrence following proximal metatarsal osteotomy. J Orthop Sci 16:760–764
doi: 10.1007/s00776-011-0136-1
pubmed: 21818604
Tejero S, González-Martín D, Martínez-Franco A, Jiménez-Diaz F, Gijón-Nogueron G, Herrera-Pérez M (2022) Intraoperative checking of the first ray rotation and sesamoid position through sonographic assistance. Arch Orthop Trauma Surg 1:1–8. https://doi.org/10.1007/s00402-022-04359-8
doi: 10.1007/s00402-022-04359-8
Okuda R, Kinoshita M, Yasuda T, Jotoku T, Kitano N, Shima H (2009) Postoperative incomplete reduction of the sesamoids as a risk factor for recurrence of hallux valgus. J Bone Jt Surg - Ser A 91:1637–1645
doi: 10.2106/JBJS.H.00796
Katsui R, Samoto N, Taniguchi A, Akahane M, Isomoto S, Sugimoto K et al (2016) Relationship between displacement and degenerative changes of the sesamoids in hallux valgus. Foot Ankle Int 37:1303–9
doi: 10.1177/1071100716661827
pubmed: 27530982
Suzuki J, Tanaka Y, Takaoka T, Kadono K, Takakura Y (2004) Axial radiographic evaluation in hallux valgus: evaluation of the transverse arch in the forefoot. J Orthop Sci 9:446–451
doi: 10.1007/s00776-004-0800-9
pubmed: 15449119
Prado M, Baumfeld T, Nery C, Mendes A, Baumfeld D (2019) Rotational biplanar Chevron osteotomy. Foot Ankle Surg. https://doi.org/10.1016/j.fas.2019.05.011
doi: 10.1016/j.fas.2019.05.011
pubmed: 31155287
Wagner P, Ortiz C, Wagner E (2017) Rotational osteotomy for hallux valgus. A new technique for primary and revision cases. Tech Foot Ankle Surg 16:3–10
doi: 10.1097/BTF.0000000000000142
pubmed: 28286430
Wagner E, Wagner P (2020) Metatarsal pronation in hallux valgus deformity: a review. JAAOS Glob Res Rev 4:6
doi: 10.5435/JAAOSGlobal-D-20-00091
Huang EH, Charlton TP, Ajayi S, Thordarson DB (2013) Effect of various hallux valgus reconstruction on sesamoid location: a radiographic study. Foot Ankle Int 34:99–103
doi: 10.1177/1071100712464356
pubmed: 23386768
Lee KB, Kim MS, Park KS, Lee GW (2019) Importance of postoperative sesamoid reduction on the outcomes of proximal chevron osteotomy for moderate to severe hallux valgus deformity. Foot Ankle Surg 25:434–440
doi: 10.1016/j.fas.2018.02.006
pubmed: 30321971
Schneider W, Aigner N, Pinggera O, Knahr K (2004) Chevron osteotomy in hallux valgus. Ten-year results of 112 cases. J Bone Joint Surg Br 86:1016–1020
doi: 10.1302/0301-620X.86B7.15108
pubmed: 15446530
Nyska M (2001) Principles of first metatarsal osteotomies. Foot Ankle Clin 6:399–408
doi: 10.1016/S1083-7515(03)00104-9
pubmed: 11692489
Kuhn J, Alvi F (2022) Hallux valgus. StatPearls Publishing
Shi GG, Whalen JL, Turner NS, Kitaoka HB (2020) Operative approach to adult hallux valgus deformity: principles and techniques. J Am Acad Orthop Surg NLM (Medline) 28:410–418
doi: 10.5435/JAAOS-D-19-00324
Mann RA (1990) Bunion surgery: decision making. Orthopedics 13:951–957
doi: 10.3928/0147-7447-19900901-07
pubmed: 2235743
Saltzman CL, Brandser EA, Berbaum KS, Degnore L, Holmes JR, Katcherian DA et al (1994) Reliability of standard foot radiographic measurements. Foot Ankle Int 15:661–665
doi: 10.1177/107110079401501206
pubmed: 7894638
Hardy RH, Clapham JCR (1951) Observations on hallux valgus. J Bone Jt Surg Br 33:376–391. https://doi.org/10.1302/0301-620X.33B3.376
doi: 10.1302/0301-620X.33B3.376
Steel MW, Johnson KA, DeWitz MA, Ilstrup DM (1980) Radiographic measurements of the normal adult foot. Foot Ankle 1:151–158
doi: 10.1177/107110078000100304
pubmed: 7319431
Siddiqui NA, LaPorta GA (2018) Minimally invasive bunion correction [Internet]. Clin Podiatr Med Surg 35:387–402
doi: 10.1016/j.cpm.2018.05.002
pubmed: 30223949
Lee M, Walsh J, Smith MM, Ling J, Wines A, Lam P (2017) Hallux valgus correction comparing percutaneous chevron/akin (PECA) and open scarf/akin osteotomies. Foot Ankle Int 38:838–846. https://doi.org/10.1177/1071100717704941
doi: 10.1177/1071100717704941
pubmed: 28476096
Nyska M, Trnka H-J, Parks BG, Myerson MS (2003) The Ludloff metatarsal osteotomy: guidelines for optimal correction based on a geometric analysis conducted on a sawbone model. Foot Ankle Int 24:34–39
doi: 10.1177/107110070302400105
pubmed: 12540079
Okuda R (2018) Proximal supination osteotomy of the first metatarsal for hallux valgus. Foot Ankle Clin 23:257–69
doi: 10.1016/j.fcl.2018.01.006
pubmed: 29729800
Frigg A, Zaugg S, Maquieira G, Pellegrino A (2019) Stiffness and range of motion after minimally invasive Chevron-akin and open scarf-akin procedures. Foot Ankle Int 40:515–525
doi: 10.1177/1071100718818577
pubmed: 30688526