Percutaneous, intra-articular, chevron osteotomy (PeICO) for the treatment of mild-to-moderate hallux valgus: a case series

Vecchio, Jorge Javier Del; Ghioldi, Mauricio Esteban; Chemes, Lucas Nicolás; Dealbera, Eric Daniel; Brue, Julieta; Dalmau-Pastor, Miki

doi:10.1007/s00264-021-05111-4

Cited by 15 publications

(15 citation statements)

References 38 publications

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“…Functionally, the AOFAS score, with the surgical technique, improved from 53.9 ± 12.3 preoperatively to 94.7 ± 6.8 postoperatively, significantly changed, and the VAS scores improved from 6.78 ± 1.74 to 1.87 ± 1.45. The functional improvements of our surgical technique were basically consistent with other modified Chevron osteotomies 19,20 . Encouragingly, none of the 23 patients (40 feet) had HV recurrence during the follow‐up time.…”

Section: Discussionsupporting

confidence: 81%

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Outcomes of V‐cut Osteotomy on the First Metatarsal Head Combined with Fixation in Mortise‐shaped Bone Groove‐Plasty and Akin Osteotomy on the First Toe for Hallux Valgus Correction

Jiao

Gan

et al. 2022

Orthopaedic Surgery

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Objective Hallux valgus (HV) is a common foot deformity, and recurrence is one of the most serious complications after HV correction. As a result, the surgical technique with a lower recurrence rate is a dream. The purpose of the article should be to observe the correction effect of hallux valgus using a novel “V‐cut” osteotomy on the first metatarsal head combined with fixation in mortise‐shaped bone groove‐plasty technique. Methods Twenty‐three consecutive patients (40 feet) with HV were included from March 2019 to May 2020, who were all treated using single screw fixation with V‐cut osteotomy on the first metatarsal head combined with mortise‐shaped metatarsal bone groove‐plasty and Akin osteotomy on the first toe for hallux valgus correction. With a mean follow‐up time of 21.7 months, the visual analogue scale (VAS) score and American Orthopedic Foot and Ankle Society (AOFAS) forefoot score and the changes of the hallux valgus angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA) were evaluated during the clinical follow‐up. The paired t test was used for analytical statistics. Results The VAS score improved from 6.78 ± 1.74 to 1.87 ± 1.45 and the AOFAS score improved from 53.9 ± 12.3 preoperatively to 94.7 ± 6.8 in the latest follow‐up postoperatively (P < 0.01). Besides, the HVA improved from 30.0 ± 6.1° to 5.7 ± 2.8° (P < 0.01); the IMA changed from 13.1 ± 2.8° into 3.3 ± 1.6° (P < 0.01); and the DMAA ameliorated from 27.0 ± 8.4° to 5.9 ± 3.5° (P < 0.01). Only five toes had slight numbness and stiffness in early postoperative period, and these symptoms disappeared completely at 6 months after the surgery. Only one foot was corrected to excess. One screw stern protruding beneath the skin happened, which needed secondary screw removal under local anesthesia. Conclusions Single screw fixation with V‐cut osteotomy on the first metatarsal head combined with fixation in mortise‐shaped metatarsal bone groove‐plasty and Akin osteotomy on the first toe is an effective way with low recurrence rate for HV correction.

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Section: Discussionsupporting

confidence: 81%

“…The functional improvements of our surgical technique were basically consistent with other modified Chevron osteotomies. 19 , 20 Encouragingly, none of the 23 patients (40 feet) had HV recurrence during the follow‐up time. This was the highlight of the modified osteotomy.…”

Section: Discussionmentioning

confidence: 98%

Outcomes of V‐cut Osteotomy on the First Metatarsal Head Combined with Fixation in Mortise‐shaped Bone Groove‐Plasty and Akin Osteotomy on the First Toe for Hallux Valgus Correction

Jiao

Gan

et al. 2022

Orthopaedic Surgery

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“…The procedure was performed bilaterally and simultaneously in 18 patients (31.5%). Twenty-two feet (29.8%) had isolated fifth S-DMMO, whereas 52 feet (70.2%) had additional procedures: 22 (29.8%) needed a modified Bosch 3 procedure and 15 feet (20.2%) a percutaneous, intra-articular, chevron osteotomy 11 technique to treat hallux valgus. Other percutaneous procedures indicated were as follows: 7 feet (9.4%) required a percutaneous Akin osteotomy 57 of the proximal phalanx of the first toe; 6 feet (8.1%) needed a DMMO of second-to-fourth metatarsals 20 because of central metatarsalgia; and 2 (2.7%) required a percutaneous procedure for lesser toe deformities.…”

Section: Resultsmentioning

confidence: 99%

Midterm Outcomes of Sliding Distal Metatarsal Minimally Invasive Osteotomy to Treat Bunionette Deformity

et al. 2022

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Background: Bunionette deformity is described as a painful bony prominence on the lateral aspect of the fifth metatarsal head. The present study prospectively assessed the clinical, functional, and radiographic outcomes of sliding distal metatarsal minimally invasive osteotomy (S-DMMO) used in a large series of patients with a midterm follow-up period. Methods: From December 2015 to December 2018, we evaluated 74 feet (57 patients). Radiologic (4-to-5 intermetatarsal angle, fifth metatarsophalangeal angle, the fifth metatarsal head width, lateral deviation angle, fifth metatarsal length, medial displacement, and elevation), clinician-reported scores (AOFAS score, visual analog scale [VAS]) and patient-reported outcomes measure (Foot and Ankle Ability Measure [FAAM] activities of daily living [ADL], FAAM sports, Manchester-Oxford Foot Questionnaire [MOXFQ], and patient satisfaction survey) were included in the analysis. The time to bone union was also assessed. Results: The average 4-to-5 intermetatarsal angle improved from 11.1 degrees preoperatively to 4.5 degrees postoperatively ( P < .001), whereas the average fifth metatarsophalangeal angle improved from 15.7 degrees preoperatively to 4.8 degrees postoperatively ( P < .001). The lateral deviation angle was found to be 2.2 degrees. The fifth metatarsal length decreased from 66.6 to 64.3 mm postoperatively. The average initial medial displacement was 4.67 mm preoperatively and 4.54 mm at final follow-up. The elevation of the fifth metatarsal head was 1.08 mm. The American Orthopaedic Foot & Ankle Society score improved from 54.3 ± 20.86 points preoperatively to 93.4 ± 17.3 ( P < .001). VAS score decreased from 7.9 to 0.7 ( P < .001). Also, FAAM ALD, FAAM Sport, and MOXFQ showed statistically significant differences ( P < .001) between preoperative and postoperative periods. Patients found the procedure excellent in 89.1% of cases, very good in 5.4%, and good in 5.4%. Bone union was obtained at 8.1 weeks. Conclusion: The most important finding of the present study is that S-DMMO showed improvement in function and pain associated with a high satisfaction rate. Also, we found substantial capacity to correct deformities and a low incidence of complications. Level of Evidence: Level IV, case series.

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“…The improvements in the function of our surgical technique were basically consistent with those of other modified chevron osteotomies. [35,36] In summary, as a new surgical technique, TCO showed good corrective effects on HVs, namely, evident improvements in HVA, IMA, DMAA, AOFAS, and VAS scores.…”

Section: Discussionmentioning

confidence: 97%

Comparison of triplanar chevron osteotomy with chevron osteotomy in hallux valgus treatment for the prevention of transfer metatarsalgia

Cao,

Guo,

et al. 2024

Medicine

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Hallux valgus (HV) is often accompanied by metatarsalgia. This study compared the radiological and clinical outcomes of new triplanar chevron osteotomy (TCO) and chevron osteotomy (CO) in the treatment of HV, especially for patients with plantar callosities and metatarsalgia. In this retrospective analysis, 90 patients (45 patients per group) with mild to moderate HV and plantar callosities were treated with TCO and CO from July 2020 to January 2022. In both procedures, the apex was located in the center of the head of the first metatarsal bone, and the CO was oriented towards the fourth MTPJ at a 60° angle. Plantar-oblique chevron osteotomy was defined as chevron osteotomy and a 20° plantar tilt; TCO was defined as plantar-oblique chevron osteotomy-based metatarsal osteotomy with a 10° tilt towards the metatarsal head. Primary outcome measures included preoperative and postoperative hallux valgus angle, 1 to 2 intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), first metatarsal length (FML), and second metatarsal head height X-ray images; clinical measurements, including visual analogue scale and American Orthopaedic Foot & Ankle Society (AOFAS) scores; changes in callosity grade and area; and changes in the number of people with metatarsalgia. Secondary outcomes included complications, recurrence rates, and cosmetic appearance. The hallux valgus angle, IMA, and DMAA were significantly lower after surgery (P < .001) in all patients. In the TCO group, the mean FML and second metatarsal head height increased significantly postoperatively (P < .001). The AOFAS and visual analogue scale scores improved postoperatively in both groups (P < .001). All patients experienced satisfactory pain relief and acceptable cosmesis. The plantar callosity areas were smaller postoperatively in both the TCO and CO groups, but the change in the area (Δarea) in the TCO group significantly differed from that in the CO group (P < .001). The number of postoperative patients with metatarsalgia and the plantar callosity grade were both significantly lower in the TCO group than in the CO group after osteotomy (P < .05). TCO prevents dorsal shift of the metatarsal head and preserves and even increases FML, thereby preventing future metatarsalgia in patients. Therefore, compared with CO, TCO has better orthopedic outcomes and is an effective method for treating mild to moderate HV and preventing transfer metatarsalgia.

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Percutaneous, intra-articular, chevron osteotomy (PeICO) for the treatment of mild-to-moderate hallux valgus: a case series

Cited by 15 publications

References 38 publications

Outcomes of V‐cut Osteotomy on the First Metatarsal Head Combined with Fixation in Mortise‐shaped Bone Groove‐Plasty and Akin Osteotomy on the First Toe for Hallux Valgus Correction

Outcomes of V‐cut Osteotomy on the First Metatarsal Head Combined with Fixation in Mortise‐shaped Bone Groove‐Plasty and Akin Osteotomy on the First Toe for Hallux Valgus Correction

Midterm Outcomes of Sliding Distal Metatarsal Minimally Invasive Osteotomy to Treat Bunionette Deformity

Comparison of triplanar chevron osteotomy with chevron osteotomy in hallux valgus treatment for the prevention of transfer metatarsalgia

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