Minimally Invasive K-wire Osteotomy versus Open Chevron Osteotomy for Hallux Valgus Correction

Abstract

Background The treatment of hallux valgus has become increasingly minimally invasive. Following the framework of three generations of minimally invasive hallux valgus techniques, we designed the minimally invasive K-wire osteotomy (MIK) technique. We aimed to compare the radiological outcomes and clinical efficacy of the MIK technique with those of open surgery and to evaluate its clinical value. Methods In this retrospective study, we analyzed the data of patients who underwent hallux valgus surgery from July 2018 to July 2021. Patients were divided into the MIK and open groups according to the surgical method. Perioperative data, radiographicmeasurements of the hallux valgus angle (HVA) and intermetatarsal angle (IMA), American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal Scale (AOFAS) scores, and visual analog scale (VAS) scores to assess efficacy were recorded. Results Seventy patients (72 feet) with hallux valgus were enrolled in this study, including 36 patients (38 feet) in the MIK group and 34 patients (34 feet) in the open group. The operation time and hospital stay were shorter in the MIK group than in the open group (P﹤0.05). No significant differences were observed in the HVA and IMA between the two groups at 6 weeks post-surgery and at the last follow-up (P﹥0.05). Six weeks post-operatively, the AOFAS and VAS scores of the MIK group were better than those of the open group (P﹤0.05). At the last follow-up, no significant difference was observed in the AOFAS and VAS scores between the two groups (P﹥0.05). The internal fixation was removed in one case in the MIK group and in two cases in the open group due to screw protrusion and skin irritation. No cases of wound infection, deformity recurrence, hallux varus, or metastatic metatarsalgia were observed in the two groups. Conclusion The MIK technique demonstrates comparable radiographic results and clinical efficacy to open surgery. It saves operation time and results in less trauma, less pain, faster functional recovery, and improved aesthetics. This technique does not require specialized equipment, making it suitable for application in most hospitals.