Minimally Invasive vs Open Akin Osteotomy

Schilde, Sebastian; Delank, Karl‐Stefan; Arbab, Dariusch; Gutteck, Natalia

doi:10.1177/1071100720962411

Cited by 15 publications

(23 citation statements)

References 24 publications

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“…Subsequently, reliable and reproducible 2D measures of HV severity such as the hallux valgus angle and intermetatarsal angle were developed and are still used ubiquitously today. 2,16,17,21,27,36,46 Further, numerous operations to normalize these quantitative measures of HV deformity also exist. 9,16,46 Despite the use of these 2D quantitative measures and operative correction of sagittal and transverse plane deformities, consistent rates of poor outcomes and HV recurrence persist with operative correction.…”

Section: Introductionmentioning

confidence: 99%

Normative Distribution of First Metatarsal Axial Rotation

Steadman

Bakshi

Arena³

et al. 2021

Foot Ankle Int.

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Background: First metatarsal (M1) axial rotation is recognized as a clinically relevant component of hallux valgus deformity. Methods to realign the M1 in 3 dimensions have been developed. One goal of these operations is to restore normal rotation of the first ray. The aim of this study is to provide estimates for the normal distribution of M1 rotation in patients without relevant anatomic pathology. Methods: Using stringent clinical and radiographic criteria, we evaluated a set of plain radiograph and weightbearing computed tomography (WBCT) images of 62 feet from a consecutive patient database. Subjects included had normal foot alignment without bunion symptoms. M1 rotation of each foot was measured using 2 unique methods (Saltzman et al and Kim et al methods). Measurement of rotation was performed by 2 observers from coronal WBCT images. Mean values and confidence intervals (CIs) of M1 rotation were calculated for each method. Inter- and intraobserver reliability values were also reported. Results: Mean M1 rotation values of 2.1 degrees (95% CI: 0.9-3.4) and 6.1 degrees (95% CI: 4.4-7.8) were identified using the Saltzman et al and Kim et al methods, respectively. Inter- and intraobserver reliability values were interpreted as excellent for both methods. Conclusion: In this study, we describe the natural distribution of the M1 axial rotation in subjects without bunion or other identifiable bony foot deformities. This information should provide a normative reference for surgeons correcting rotational issues of the first metatarsal. Level of Evidence: Level III.

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Section: Introductionmentioning

confidence: 99%

Normative Distribution of First Metatarsal Axial Rotation

Steadman

Bakshi

Arena³

et al. 2021

Foot Ankle Int.

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“…Follow-up times were highly variable, ranging from 6 months to 7 years. Among the included studies, 8 studies ( 15 , 17 , 24 , 26 , 28 , 29 , 31 , 35 ) were RCTs, 2 studies ( 4 , 14 ) were prospective comparative studies, and 12 studies ( 5 , 13 , 16 , 18 , 22 , 23 , 25 , 27 , 30 , 32 – 34 ) were retrospective comparative studies. A total of 10 studies ( 13 , 17 , 22 – 28 , 32 ) reported on the 2G percutaneous hallux valgus surgery, in which 7 studies ( 13 , 22 – 25 , 28 ) involved Bösch osteotomy and 3 studies ( 17 , 26 , 27 ) involved a simple, an effective, a rapid, and an inexpensive (SERI) technique.…”

Section: Resultsmentioning

confidence: 99%

“…Siddiqui et al ( 32 ) performed a retrospective comparison between Bösch and Chevron surgery. Nine studies ( 5 , 14 – 16 , 18 , 29 , 30 , 34 , 35 ) reported on the 3G percutaneous hallux valgus surgery, including percutaneous chevron–akin (PECA) and MICA. Brogan et al ( 5 ) performed a retrospective study to compare between the PECA and Chevron technique.…”

Section: Resultsmentioning

confidence: 99%

“…Lu et al conducted a meta-analysis in which most of the included studies were of low or moderate quality ( 12 ). In the last 3 years, several new studies ( 13 – 18 ) performed a comparison between MIS and open surgery for hallux valgus have reported. Therefore, we conducted this updated meta-analysis and included more OMs to comprehensively evaluate the efficacy of MIS vs. open surgery for hallux valgus.…”

Section: Introductionmentioning

confidence: 99%

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Minimally Invasive vs. Open Surgery for Hallux Valgus: A Meta-Analysis

Wang

Ding

et al. 2022

Front. Surg.

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PurposeIn recent years, minimally invasive surgery (MIS) for hallux valgus has emerged and gained popularity. To date, evidence on the benefits of MIS for hallux valgus is still controversial. This updated meta-analysis aimed to comprehensively evaluate the efficiency of MIS vs. open surgery for hallux valgus.MethodsA systematic literature search of PubMed, Embase, and the Cochrane Library was performed. Two independent reviewers conducted data extraction and analyzed data with R software. Data were presented with risk ratio (RR) and standardized mean difference (SMD) along with 95% confidence interval (CI).ResultsA total of 22 studies in which there were 790 ft treated with the MIS procedure and 838 ft treated with an open procedure were included. The correction of sesamoid position was better in the MIS group. The post-operative distal metatarsal articular angle (DMAA) of the MIS group was lower. There was less pain at the early phase in the MIS group. The MIS group had a shorter surgery time and shorter hospitalization time compared with the open group. Our meta-analysis revealed no statistically significant difference in hallux valgus angle (HVA), first intermetatarsal angle (IMA), the first metatarsal shortening, the American Orthopedic Foot and Ankle Society (AOFAS) score, visual analog scale (VAS) score at the final follow-up or complication rate (when all studies were considered). When taking into consideration only randomized controlled trial (RCT), the AOFAS score was higher in the MIS group while HVA, IMA, DMAA, and complication rate remained no significance. Post-operative IMA of the MIS group was significantly lower when only studies reporting the second-generation (2G) MIS were included. When just studies adopting the third-generation (3G) MIS were included, the HVA and DMAA were lower in the MIS group.ConclusionThe MIS procedures were more effective than open surgeries in the treatment of hallux valgus. Moreover, the MIS group achieved better radiologic and clinical outcomes compared with the open group.

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“…Four feet also underwent capsulotomy, collateral ligaments release and extensor tendon lengthening of the metatarsophalangeal joint for dorsal dislocation of clawed lesser toes. No other additional surgeries such as Akin, 16 Weil, 17 or other lesser metatarsal osteotomies was performed.…”

Section: Methodsmentioning

confidence: 99%

The metatarsaus adductus effect by the syndesmosis procedure for hallux valgus correction

Lam

2021

Bone & Joint Open

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Aims The purpose of this study is to examine the adductus impact on the second metatarsal by the nonosteotomy nonarthrodesis syndesmosis procedure for the hallux valgus deformity correction, and how it would affect the mechanical function of the forefoot in walking. For correcting the metatarsus primus varus deformity of hallux valgus feet, the syndesmosis procedure binds first metatarsal to the second metatarsal with intermetatarsal cerclage sutures. Methods We reviewed clinical records of a single surgical practice from its entire 2014 calendar year. In total, 71 patients (121 surgical feet) qualified for the study with a mean follow-up of 20.3 months (SD 6.2). We measured their metatarsus adductus angle with the Sgarlato’s method (SMAA), and the intermetatarsal angle (IMA) and metatarsophalangeal angle (MPA) with Hardy’s mid axial method. We also assessed their American Orthopaedic Foot & Ankle Society (AOFAS) clinical scale score, and photographic and pedobarographic images for clinical function results. Results SMAA increased from preoperative 15.9° (SD 4.9°) to 17.2° (5.0°) (p < 0.001). IMA and MPA corrected from 14.6° (SD 3.3°) and 31.9° (SD 8.0°) to 7.2° (SD 2.2°) and 18.8° (SD 6.4°) (p < 0.001), respectively. AOFAS score improved from 66.8 (SD 12.0) to 96.1 (SD 8.0) points (p < 0.001). Overall, 98% (119/121) of feet with preoperative plantar calluses had them disappeared or noticeably subsided, and 93% (113/121) of feet demonstrated pedobarographic medialization of forefoot force in walking. We reported all complications. Conclusion This study, for the first time, reported the previously unknown metatarsus adductus side-effect of the syndesmosis procedure. However, it did not compromise function restoration of the forefoot by evidence of our patients' plantar callus and pedobarographic findings. Level of Clinical Evidence: III Cite this article: Bone Jt Open 2021;2(3):174–180.

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Minimally Invasive vs Open Akin Osteotomy

Cited by 15 publications

References 24 publications

Normative Distribution of First Metatarsal Axial Rotation

Normative Distribution of First Metatarsal Axial Rotation

Minimally Invasive vs. Open Surgery for Hallux Valgus: A Meta-Analysis

The metatarsaus adductus effect by the syndesmosis procedure for hallux valgus correction

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