Radiographic Outcomes of a Percutaneous, Reproducible Distal Metatarsal Osteotomy for Mild and Moderate Bunions: A Multicenter Study

Siddiqui, Noman A.; LaPorta, Guido A.; Walsh, Amanda L.; Abraham, Jossie S.; Beauregard, Serge; Gdalevitch, Marie

doi:10.1053/j.jfas.2019.04.012

Cited by 26 publications

(16 citation statements)

References 44 publications

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“…Second-generation techniques incorporated a transverse osteotomy and temporary Kirschner (K) wire fixation. 2,16,19 Third-generation techniques incorporated screw fixation to chevron osteotomies to augment stability of the operative construct. 2,7,23…”

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confidence: 99%

“…12,14,24 Radiographic outcomes in MIS have also demonstrated equivalency in correcting standard measurements in hallux valgus surgery. 2,7,16,19 What remains unclear is the biomechanical strength of MIS constructs—specifically, a MIS chevron or transverse osteotomy with screw fixation. The goal of this study was to evaluate the biomechanical stability of chevron and transverse osteotomy techniques in a cadaveric model.…”

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confidence: 99%

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Biomechanical Comparison of 2 Common Techniques of Minimally Invasive Hallux Valgus Correction

Aiyer

Massel

Siddiqui³

et al. 2020

Foot Ankle Int.

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Background: Hallux valgus is one of the most common surgically corrected forefoot deformities. Compared to open procedures, minimally invasive (MIS) treatment of hallux valgus has resulted in decreased operative time, reduced complication rates, and greater patient satisfaction. Historically, distal chevron osteotomies are the standard for moderate hallux valgus correction. To our knowledge, no studies have evaluated biomechanical strength of transverse and chevron distal first metatarsal osteotomy (DMO) constructs. The purpose of this study was to evaluate the biomechanical strength of these techniques. Methods: Eighteen cadaveric specimens (9 matched pairs) were randomized to transverse or chevron DMO. Each technique was performed by a separate fellowship-trained orthopedic foot and ankle surgeon. Radiographic images were analyzed. Biomechanical testing was performed using Instron Mechanical System. Ultimate load to failure, yield load, and stiffness were assessed. A 10-N preload was applied to the sesamoid bones for stability. A coaxial compression rate (10 mm/min) was applied until failure was observed. Mean and standard deviations were compared. All cadaveric specimens were male. Results: There was no significant difference in percent metadiaphyseal shift between osteotomies ( P = .453). The most common mode of failure was fracture at screw insertion site (55.6%), followed by failure at osteotomy site (44.4%). A trend toward increased ultimate load to failure ( P = .480), yield load ( P = .054), and stiffness ( P = .438) among transverse compared to chevron osteotomy was observed, but this difference was not statistically significant. Conclusion: Biomechanical testing demonstrated no significant difference in ultimate load, yield load, and stiffness between MIS transverse and chevron osteotomy constructs; a trend toward increased strength in the transverse osteotomy cohort was observed. Chevron osteotomies may result in early failure by relative ease of cutout through cancellous bone compared to transverse osteotomies in which failure requires cortical cutout. Clinical Relevance: Use of MIS techniques for hallux valgus correction is gaining clinical traction. Although various clinical studies have evaluated outcomes of these MIS techniques, biomechanical studies have been minimal. Specifically, the potential biomechanical benefits of various MIS hallux valgus osteotomy techniques have not been delineated to date. The content of this manuscript is quite timely, given the rise in use of these MIS techniques.

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confidence: 99%

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confidence: 99%

Biomechanical Comparison of 2 Common Techniques of Minimally Invasive Hallux Valgus Correction

Aiyer

Massel

Siddiqui³

et al. 2020

Foot Ankle Int.

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“…Дистальну остеотомію застосовують за умов деформацій легкого та середнього ступеня тяжкості, але вона протипоказана в разі важких випадків [32]. У 1881 році Reverdin описав дистальну коригувальну клиноподібну остеотомію І плеснової кістки із вершиною клина, спрямованою латерально, яка доповнювалася резекцією кістково-хрящового екзостозу головки І плеснової кістки.…”

Section: результати та їх обговоренняunclassified

Surgical Treatment of Valgus Deformity of Great Toe (Literature Review)

Prozorovskiy¹

2021

OTP

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The most common manifestation of static deformity of the forefoot is hallux valgus. This symptom complex consists of valgus deviation of the first toe, varus deviation of the first metatarsal bone, and the presence of osteochondral exostosis along the medial surface of the head of the first metatarsal bone. The objective of the work was to determine the most common methods of treatment of hallux valgus and varus deformities of the first metatarsal bone on the basis of the analyzed published literature. Methods. We analyzed publications from the Google search engine, electronic databases PubMed, Google Scholar, archives of specialized journals and other relevant sources of scientific and medical information. Results. Based on the analysis of literary sources, the development of forefoot surgery from the 18th century to the present day was highlighted in the historical aspect. The greatest attention is paid to the use of various osteotomies of the first metatarsal bone for the correction of hallux valgus. In addition, special attention is paid to the developmentof various complications at osteotomies. Conclusions. The problem of surgical correction of hallux valgus is multifaceted and extremely interesting, containing a large number of nuances and hidden complexities. For quite a long time, there has been an improvement in various surgical techniques and methods of fixation. Considering the great variability of the clinical manifestations of hallux valgus, for many years no universal method of treatingthis pathology has been proposed. Therefore, in the future, most likely, individual and differentiated approaches to the choice of one or another method of surgical intervention will be considered, depending on what type of deformity of the forefoot the orthopedisttraumatologist has to meet in his practice.

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“…The rates of the complications were diverse widely even within the same technique. The Bosch technique was reported to have 0% complication rates [21] or 22% [22] or27.2% [23]. The Reverdin-Isham technique was reported to vary from a 5% [24] to a 73% [25] rate of complications.…”

Section: Clinical Outcomes Clinicalmentioning

confidence: 99%

A New Minimally Invasive Surgery of Hallux Valgus: Technique and Preliminary Outcomes

Guo

et al. 2020

Preprint

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PurposeThis study aimed to present a new minimally invasive surgery (MIS) technique and evaluate the safety and efficacy for correction of hallux valgus deformity at a preliminary follow-up.Methods48 consecutive feet that underwent a new MIS of hallux valgus with a mean 17.6 months follow-up (range 9 to 28 months). This technique uses a new osteotomy of the first metatarsal with screw fixation and percutaneous Weil osteotomy of lesser metatarsal without fixation. All patients were clinically evaluated using the Manchester-Oxford Foot Questionnaire (MOXFQ), American Orthopedic Foot & Ankle Society Hallux Metatarsophalangeal-Interphalangeal score (AOFAS HMI) and visual analogue scale (VAS). Radiographic measures included hallux valgus angle (HVA), intermetatarsal angle (IMA) and the length of the first metatarsal. ResultsThere was significant improvement in the radiographic parameters(P<0.001). The IMA decreased from 13.3° to 9.8°, the HVA improved from 35.9° to 17.9° and the mean MT length decreased by 4 mm. There was significant improvement of VAS in the postoperative 2 weeks (P < .001). There were significant improvements in the MOXFQ scores and AOFAS HMI scores, respectively. The total rate of complication was 10.4%.ConclusionThe preliminary radiographic and clinical outcomes of this new minimally invasive surgery show that it is a safe procedure and had significantly less pain in the first 2 weeks following surgery.

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Radiographic Outcomes of a Percutaneous, Reproducible Distal Metatarsal Osteotomy for Mild and Moderate Bunions: A Multicenter Study

Cited by 26 publications

References 44 publications

Biomechanical Comparison of 2 Common Techniques of Minimally Invasive Hallux Valgus Correction

Biomechanical Comparison of 2 Common Techniques of Minimally Invasive Hallux Valgus Correction

Surgical Treatment of Valgus Deformity of Great Toe (Literature Review)

A New Minimally Invasive Surgery of Hallux Valgus: Technique and Preliminary Outcomes

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