Bunionette deformity corrected with “shortening” scarf osteotomy of the fifth metatarsal: mid-term results of a 34-cases

Nečas, Libor; Hrubina, M; Skoták, M; Melišík, Marian; Lisý, P.; Cibula, Zoltán

doi:10.1016/j.fas.2019.06.001

Cited by 8 publications

(13 citation statements)

References 17 publications

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“…Heckman et al (18) evaluated 63 patients treated with distal osteotomy of the fifth metatarsal using an open technique and reported an infection rate of 9.5%, of which 50% required surgical reintervention with resection of the metatarsal head. Recently, Necas et al (19) retrospectively evaluated 34 feet with bunionette treated with a scarf osteotomy using an open technique and fixation with screws and reported complications in 5 cases (14.7%). Although within acceptable limits, surgical reintervention was required in 3 of these cases (8.8%) due to postoperative infection, transfer metatarsalgia, and hardware migration (19) .…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Necas et al (19) retrospectively evaluated 34 feet with bunionette treated with a scarf osteotomy using an open technique and fixation with screws and reported complications in 5 cases (14.7%). Although within acceptable limits, surgical reintervention was required in 3 of these cases (8.8%) due to postoperative infection, transfer metatarsalgia, and hardware migration (19) .…”

Section: Discussionmentioning

confidence: 99%

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Minimally invasive bunionette treatment

Lima

Baumfeld

Maciel³

et al. 2020

J Foot Ankle

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Objective: To report the clinical and radiographic results of surgical treatment of bunionette deformity with a minimally invasive technique without the use of hardware. Methods: This is a case series of 13 patients (14 feet) with a diagnosis of bunionette surgically treated with a minimally invasive osteotomy of the fifth metatarsal. All patients completed the American Orthopedic Foot and Ankle Society (AOFAS) score and a visual analog scale (VAS) for pain preoperatively and in the last follow-up visit. Radiographic measurements included the fourth-fifth intermetatarsal angle (4-5 IMA) and the fifth metatarsophalangeal (MTP-5) angle. Complications and level of patient satisfaction were also documented. Results: Mean follow-up was 12.3 months. The mean AOFAS score increased from 51.3 to 94.0, and the VAS score decrease from 7.5 to 1.1. The MTP-5 angle decreased from 11.5º to 2.3º, and the 4-5 IMA decreased from 9.8º to 3.6º. These outcomes showed a statistically significant difference (p<0.001). The only complication was hypertrophic callus formation observed in 3 feet (21.4%). There were no cases of infection, neurapraxia, wound dehiscence, nonunion, or deformity recurrence. Ten patients rated their outcome as excellent and 3 as good. Conclusion: Treatment of bunionette with percutaneous osteotomy of the fifth metatarsal without the use of hardware showed good clinical and radiographic results, with a low complication rate and a high level of patient satisfaction. Level of Evidence IV; Therapeutic Studies; Case Series.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Minimally invasive bunionette treatment

Lima

Baumfeld

Maciel³

et al. 2020

J Foot Ankle

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“…In bunionette surgery, the clinical outcome of the percutaneous technique is comparable to standard surgical procedures but both techniques have some specific benefits and drawbacks [10]. The conventional open surgical techniques are related to a higher risk of specific complications due to the open approach and the use of hardware: wound healing problems, infections and hardware problems [11,12]. Necas et al reported 5 complications in 34 open bunionette corrections [12].…”

Section: Discussionmentioning

confidence: 99%

Consensus in percutaneous bunionette correction

Michels

Demeulenaere²,

Cordier

2021

Orthopaedics & Traumatology: Surgery & Research

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“…By and large, isolated first metatarsal dorsiflexion osteotomies were reserved for patients with a correctable hindfoot valgus, with the majority of the pressure symptoms distributed in the forefoot. Adjunct procedures, including a fifth ray procedure, were not required and certainly did not influence the study’s functional outcome [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Making Things Easier: A Simple Novel Method to Fix a Dorsiflexion Osteotomy of the First Metatarsal

et al. 2020

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A first ray dorsiflexion osteotomy is commonly performed for cavovarus foot correction. There are multiple techniques to fix this osteotomy, ranging from wires, screws, and plates or a combination of these. We present our results using a varisation staple (Biomet©) as an alternative fixation device. We performed a retrospective outcome analysis of a consecutive series of 10 cavovarus feet that underwent a dorsiflexion osteotomy (dorsal closing wedge) of the first metatarsal fixed with two varisation staples. The results were measured at a mean three monthly follow-ups and included union and complication rates, as well as clinical and radiographic assessment of cavus deformity correction. There was a 100% union rate with no complications or cases of delayed union. No metalwork removal was requested in any case at follow-up. First ray dorsiflexion osteotomies are most commonly fixed using a 3.5mm cortical screw. We demonstrate that our alternative and novel technique using varisation staples achieved a 100% union rate while avoiding the prominent hardware complications known to occur with cortical screws or plates.

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Bunionette deformity corrected with “shortening” scarf osteotomy of the fifth metatarsal: mid-term results of a 34-cases

Cited by 8 publications

References 17 publications

Minimally invasive bunionette treatment

Minimally invasive bunionette treatment

Consensus in percutaneous bunionette correction

Making Things Easier: A Simple Novel Method to Fix a Dorsiflexion Osteotomy of the First Metatarsal

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