Minimally Invasive Retrocapital Osteotomy of the First Metatarsal in Hallux Valgus Deformity

Magnan, Bruno; Samaila, Elena Manuela; Viola, Giovanna; Bartolozzi, Pietro

doi:10.1007/s00064-008-1231-0

Cited by 38 publications

(21 citation statements)

References 4 publications

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“…10,26,28 These results are also comparable to the corrections achieved with second-generation MIS techniques and other open surgeries. 32,36 Our results of the AOFAS score for MICA and scarf-Akin are comparable to the results in the literature: MICA is reported to improve from 59-61 to 87-89 points and scarf-Akin from 53-57 to 84-88 points. 26,28…”

Section: Discussionsupporting

confidence: 86%

Stiffness and Range of Motion After Minimally Invasive Chevron-Akin and Open Scarf-Akin Procedures

et al. 2019

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Background: Stiffness after open hallux valgus surgery affects 7% to 38% of patients. Minimally invasive surgery (MIS) is thought to decrease this rate by reducing soft tissue trauma. MIS, now in its third generation, is advertised as delivering results superior to open surgery. However, no studies have reported stiffness or range of motion (ROM). Methods: Between January 2014 and December 2015, a total of 50 patients received open scarf-Akin surgery and 48 received minimally invasive Chevron Akin (MICA) surgery. The endpoints were American Orthopaedic Foot & Ankle Society (AOFAS) score, range of motion, visual analog scale for pain, scar length, and subjective foot value. The minimal follow-up time was 2 years. Results: Moderate stiffness occurred in 3 cases in both groups. In MICA, extension increased by 10 degrees while it remained unchanged in scarf. Both groups showed similar improvements in AOFAS score, pain, and subjective foot value. Radiographic evidence of correction was comparable, except for an increased shortening of the first metatarsal by 3 mm in MICA. The scars were smaller in MICA (1.2 cm) than in scarf (5 cm). Wound problems included delayed healing in 10% in scarf and wound infections in 4% in MICA. The rate of recurrence and other complications were comparable, except for reoperations, which were higher in MICA (27% mainly for protruding screws) than in scarf (8% mainly for stiffness). In MICA, 14% were intraoperatively converted to open surgery. Conclusion: MICA showed no advantages over scarf other than a shorter scar. The observed gain in extension could be related to the increased shortening of the first metatarsal because of the size of the burr. Level of Evidence: Level II, prospective cohort (nonrandomized, comparative) study.

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Section: Discussionsupporting

confidence: 86%

Stiffness and Range of Motion After Minimally Invasive Chevron-Akin and Open Scarf-Akin Procedures

et al. 2019

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“…According to Cancilleri et al,1 AOFAS values >85 points are considered very satisfactory. Our results for the post‐operative AOFAS values parallel those achieved with the open McBride16 and Chevron17 techniques, and with other percutaneous techniques such as distal22 and Reverdin‐Isham23 percutaneous osteotomies. The DSTR‐Akin percutaneous technique achieves an appropriate correction of the deformity, which is radiographically similar to its open surgery counterpart 24.…”

Section: Discussionsupporting

confidence: 78%

Dynamic plantar pressure analysis and midterm outcomes in percutaneous correction for mild hallux valgus

Nova

Sánchez-Rodríguez

Leal-Muro

et al. 2011

Journal Orthopaedic Research

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Mild hallux valgus (HV), which can lead to alteration of the plantar pressure pattern with an overpressure under the hallux, can be repaired percutaneously. Our goals were to determine whether the percutaneous distal soft tissue release (DSTR)-Akin procedure restores the loading pattern and to evaluate which are the determinants of the measures of post-operative outcome. Seventynine percutaneous DSTR-Akin procedures were performed in the same number of patients. The plantar pressure patterns were evaluated using the BioFoot/IBV 1 in-shoe system and compared with measurements from 98 controls. The clinical and radiological outcome parameters measured were the pre-and post-operative AOFAS scores, and the first intermetatarsal, hallux abductus, and first metatarsal-hallux declination angles (FIMA, HAA, FMHDA) in weight-bearing radiographs. The mean follow-up was 28.1 (range 24-33) months. The plantar pressure analysis showed a significant decrease (328-152 kPa, p ¼ 0.001) in the mean pressure under the hallux. Significant improvements occurred in the AOFAS scores, and angular deviations were reduced. The post-operative HAA correlated with the mean pressure under the 1st toe (r 2 ¼ 0.132, p < 0.001). The DSTR-Akin percutaneous technique in mild HV restores physiological patterns of pressure on the hallux and achieves significant correction of radiographic angles and commensurate improvement in clinical status. ß

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“…This can certainly be achieved using minimally invasive hallux valgus surgery. Comparisons of minimally invasive and open techniques revealed similar results of both techniques [17,31,32,34,44,45].…”

Section: Discussionmentioning

confidence: 77%

Minimally invasive hallux valgus surgery: a critical review of the evidence

Trnka

Krenn

Schuh

2013

International Orthopaedics (SICOT)

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This systematic review aims to illustrate the published results of "minimally invasive" procedures for correction of hallux valgus. Based on former systematic reviews on that topic, the literature search was organised by two independent investigators. MEDLINE was systematically searched for available studies. The keywords used were "hallux valgus", "bunion", "percutaneous surgery", "minimally invasive surgery", "arthroscopy", "Bosch" and "SERI". Studies were assessed using the level of evidence rating. A total of 21 papers were included in this review. These studies described a total of 1,750 patients with 2,195 instances of percutaneous, minimally invasive or arthroscopic hallux valgus surgery. Clinical reports of results after minimally invasive hallux valgus surgery at meetings are common. Published results in peer-reviewed journals are less common and the majority of papers are level IV studies according to the level of evidence ratings. We found one level II and three level III studies. Reported complications seem to be less than one may see in one's own clinical practice. This possible bias may be related to the fact that most studies are published by centres performing primarily minimally invasive hallux valgus surgery.

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Minimally Invasive Retrocapital Osteotomy of the First Metatarsal in Hallux Valgus Deformity

Cited by 38 publications

References 4 publications

Stiffness and Range of Motion After Minimally Invasive Chevron-Akin and Open Scarf-Akin Procedures

Stiffness and Range of Motion After Minimally Invasive Chevron-Akin and Open Scarf-Akin Procedures

Dynamic plantar pressure analysis and midterm outcomes in percutaneous correction for mild hallux valgus

Minimally invasive hallux valgus surgery: a critical review of the evidence

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