Pin fixation is an effective method for fixation of bunion osteotomy with various procedures: a retrospective cohort study.
Hallux valgus deformity
Osteotomy
Pin fixation
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
11 Sep 2024
11 Sep 2024
Historique:
received:
02
09
2023
accepted:
05
09
2024
medline:
12
9
2024
pubmed:
12
9
2024
entrez:
11
9
2024
Statut:
epublish
Résumé
Various fixation devices are available for bunion osteotomy. In this study, we evaluated the radiographic outcomes, postoperative complications, and recurrence rate in a series of hallux valgus deformities treated with various osteotomy procedures using a pin for the fixation of the osteotomy. Two-hundred forty-seven patients with hallux valgus deformity managed with a Simple, Effective, Rapid and Inexpensive (SERI) osteotomy, distal chevron osteotomy, or proximal crescentic osteotomy and K-wire fixation were included. The mean follow-up of the patients was 53.9 ± 8.9 months. Radiographic evaluations included the assessment of the Hallux valgus angle (HVA), intermetatarsal angle (IMA), and union. Clinical evaluations included the assessment of the range of motion, pain in the first metatarsophalangeal joint, and patient satisfaction. In the last visit, the mean improvement of HVA was 23.9 ± 9.1º (P < 0.001). The mean IMA improvement was 6.1 ± 6º (P < 0.001). The mean metatarsophalangeal flexion and extension were 33 ± 10.7º and 34.6 ± 9.2º, respectively. Postoperative complications included pin tract infection in eight (3.2%) patients, deep infection in five (2%) patients, and early pin complication in four (1.6%) patients. Recurrence was observed in five (2%) patients. Twenty-three (9.3%) patients had slight pain in the last follow-up. The mean surgical time was smaller in the SERI osteotomy (P < 0.001). The mean hospitalization period was longer in the proximal osteotomy group (P = 0.039). The mean metatarsophalangeal flexion and extension were significantly smaller in the distal chevron osteotomy (P = 0.046 and P = 0.037, respectively). 90% of patients were satisfied or very satisfied with the surgical outcomes. K-wire fixation is a safe and effective device for the fixation of bunion osteotomy, and this effectiveness is even higher with SERI and proximal crescentic osteotomy.
Sections du résumé
BACKGROUND
BACKGROUND
Various fixation devices are available for bunion osteotomy. In this study, we evaluated the radiographic outcomes, postoperative complications, and recurrence rate in a series of hallux valgus deformities treated with various osteotomy procedures using a pin for the fixation of the osteotomy.
METHODS
METHODS
Two-hundred forty-seven patients with hallux valgus deformity managed with a Simple, Effective, Rapid and Inexpensive (SERI) osteotomy, distal chevron osteotomy, or proximal crescentic osteotomy and K-wire fixation were included. The mean follow-up of the patients was 53.9 ± 8.9 months. Radiographic evaluations included the assessment of the Hallux valgus angle (HVA), intermetatarsal angle (IMA), and union. Clinical evaluations included the assessment of the range of motion, pain in the first metatarsophalangeal joint, and patient satisfaction.
RESULTS
RESULTS
In the last visit, the mean improvement of HVA was 23.9 ± 9.1º (P < 0.001). The mean IMA improvement was 6.1 ± 6º (P < 0.001). The mean metatarsophalangeal flexion and extension were 33 ± 10.7º and 34.6 ± 9.2º, respectively. Postoperative complications included pin tract infection in eight (3.2%) patients, deep infection in five (2%) patients, and early pin complication in four (1.6%) patients. Recurrence was observed in five (2%) patients. Twenty-three (9.3%) patients had slight pain in the last follow-up. The mean surgical time was smaller in the SERI osteotomy (P < 0.001). The mean hospitalization period was longer in the proximal osteotomy group (P = 0.039). The mean metatarsophalangeal flexion and extension were significantly smaller in the distal chevron osteotomy (P = 0.046 and P = 0.037, respectively). 90% of patients were satisfied or very satisfied with the surgical outcomes.
CONCLUSION
CONCLUSIONS
K-wire fixation is a safe and effective device for the fixation of bunion osteotomy, and this effectiveness is even higher with SERI and proximal crescentic osteotomy.
Identifiants
pubmed: 39261842
doi: 10.1186/s12891-024-07850-y
pii: 10.1186/s12891-024-07850-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
729Informations de copyright
© 2024. The Author(s).
Références
Mann RA, Coughlin MJ. Hallux valgus–etiology, anatomy, treatment and surgical considerations. Clin Orthop Relat Res. 1981(157):31–41.
Trnka HJ, Percutaneous. MIS and open hallux valgus surgery. EFORT Open Rev. 2021;6(6):432–8.
doi: 10.1302/2058-5241.6.210029
pubmed: 34267933
pmcid: 8246107
Zirngibl B, Grifka J, Baier C, Götz J. [Hallux valgus: etiology, diagnosis, and therapeutic principles]. Der Orthopade. 2017;46(3):283–96.
doi: 10.1007/s00132-017-3397-3
pubmed: 28251259
Ozkurt B, Aktekin CN, Altay M, Belhan O, Tabak Y. Range of motion of the first metatarsophalangeal joint after chevron procedure reinforced by a modified capsuloperiosteal flap. Foot Ankle Int. 2008;29(9):903–9.
doi: 10.3113/FAI.2008.0903
pubmed: 18778668
Dhukaram V, Hullin MG, Senthil Kumar C. The Mitchell and Scarf osteotomies for hallux valgus correction: a retrospective, comparative analysis using plantar pressures. J Foot Ankle Surg. 2006;45(6):400–9.
doi: 10.1053/j.jfas.2006.08.001
pubmed: 17145464
Ray JJ, Friedmann AJ, Hanselman AE, Vaida J, Dayton PD, Hatch DJ, et al. Hallux Valgus Foot Ankle Orthop. 2019;4(2):2473011419838500.
pubmed: 35097321
Torkki M, Malmivaara A, Seitsalo S, Hoikka V, Laippala P, Paavolainen P. Surgery vs orthosis vs watchful waiting for hallux valgus: a randomized controlled trial. JAMA. 2001;285(19):2474–80.
doi: 10.1001/jama.285.19.2474
pubmed: 11368700
Robinson AH, Limbers JP. Modern concepts in the treatment of hallux valgus. J Bone Joint Surg Br. 2005;87(8):1038–45.
doi: 10.1302/0301-620X.87B8.16467
pubmed: 16049235
Trnka HJ. Osteotomies for hallux valgus correction. Foot Ankle Clin. 2005;10(1):15–33.
doi: 10.1016/j.fcl.2004.10.002
pubmed: 15831256
Sammarco VJ, Acevedo J. Stability and fixation techniques in first metatarsal osteotomies. Foot Ankle Clin. 2001;6(3):409–32. v-vi.
doi: 10.1016/S1083-7515(03)00105-0
pubmed: 11692490
Park CH, Ahn JY, Kim YM, Lee WC. Plate fixation for proximal chevron osteotomy has greater risk for hallux valgus recurrence than Kirschner wire fixation. Int Orthop. 2013;37(6):1085–92.
doi: 10.1007/s00264-013-1822-8
pubmed: 23423428
pmcid: 3664155
Jentzsch T, Renner N, Niehaus R, Farei-Campagna J, Deggeller M, Scheurer F, et al. The influence of the number of screws and additional surgical procedures on outcome in hallux valgus treatment. J Orthop Surg Res. 2018;13(1):99.
doi: 10.1186/s13018-018-0796-z
pubmed: 29695272
pmcid: 5918987
Mc BE. Hallux valgus, bunion deformity; its treatment in mild, moderate and severe stages. J Int Coll Surg. 1954;21(1 1):99–105.
Giannini S, CECCARELLI F, BEVONI R, VANNINI F. Hallux valgus surgery: the minimally invasive bunion correction (SERI). Tech Foot Ankle Surg. 2003;2(1):11–20.
doi: 10.1097/00132587-200303000-00003
AUSTIN DW, LEVENTEN EO. A new osteotomy for hallux valgus: a horizontally directed V displacement osteotomy of the metatarsal head for hallux valgus and primus varus. Clin Orthop Relat Res. 1981;157:25–30.
doi: 10.1097/00003086-198106000-00007
Fox IM, Caffiero L, Pappas E. The crescentic first metatarsal basilar osteotomy for correction of metatarsus primus varus. J Foot Ankle Surg. 1999;38(3):203–7.
doi: 10.1016/S1067-2516(99)80053-2
pubmed: 10384359
Magnan B, Pezzè L, Rossi N, Bartolozzi P. Percutaneous distal metatarsal osteotomy for correction of hallux valgus. J Bone Joint Surg Am. 2005;87(6):1191–9.
pubmed: 15930526
Mancuso JE, Abramow SP, Bloom WB, Carioscia MP, Landsman MJ. Smooth Kirschner (K) wire fixation of distal metaphyseal osteotomy bunionectomies: a 10-year retrospective survey. J Foot Surg. 1992;31(3):276–84.
pubmed: 1619229
Baig MN, Baig U, Tariq A, Din R. A prospective study of distal metatarsal Chevron osteotomies with K-Wire fixations to treat Hallux Valgus deformities. Cureus. 2017;9(9):e1704.
pubmed: 29167752
pmcid: 5698042
Rogero RG, Corr D, O’Neil JT, Raikin SM. Two weeks of Kirschner Wire Fixation following Chevron Osteotomy for Hallux Valgus. Foot Ankle Orthop. 2020;5(4):2473011420S00413.
doi: 10.1177/2473011420S00413
pmcid: 8702895
Jung HG, Lee JS, Lee DO, Kim SW, Coruña JA. Comparison between pin fixation and combined screw fixation in Proximal Chevron Metatarsal Osteotomy for Hallux Valgus deformity correction. Clin Orthop Surg. 2021;13(1):110–6.
doi: 10.4055/cios20003
pubmed: 33747387
pmcid: 7948032
Winemaker MJ, Amendola A. Comparison of Bioabsorbable Pins and Kirschner Wires in the fixation of Chevron Osteotomies for Hallux Valgus. Foot Ankle Int. 1996;17(10):623–8.
doi: 10.1177/107110079601701007
pubmed: 8908489
Pepper A, Li W, Kingery WS, Angst MS, Curtin CM, Clark JD. Changes resembling complex regional pain syndrome following surgery and immobilization. J Pain. 2013;14(5):516–24.
doi: 10.1016/j.jpain.2013.01.004
pubmed: 23453564
pmcid: 3644418