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Espinosa-Uribe AG, Fernández-Garza FA, Muñoz-Leija D, Vílchez-Cavazos JF, Quiroga-Garza A, Peña-Martínez VM, Elizondo-Omaña RE, Gutiérrez-de la O J. A comparison of three techniques for the osteosynthesis after minimal invasive osteotomies for hallux valgus. INTERNATIONAL ORTHOPAEDICS 2024; 48:2137-2143. [PMID: 38589709 DOI: 10.1007/s00264-024-06178-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/02/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE Third and fourth-generation minimal invasive osteotomies (MIO) for the treatment of hallux valgus (HV) have become popular procedures worldwide with promising results due to the improvement in the fixation method. The tricortical cannulated screw placement remains a complex procedure that is technically challenging and requires a long skill learning curve with high radiation exposure mainly in the form of intensifier shots (IS) required for the MIO fixation. This study aims to compare the number of X-ray IS required using three different techniques for the cannulated guide placement. METHODS A retrospective cross-sectional observational and comparative study was conducted to assess the number of X-rays IS required for correct cannulated screw guide placement using three different techniques: traditional perforator, the drill and joystick, and K-wire first techniques. RESULTS A total of 53 MIS procedures from thirty-one patients in two different hospitals were included. IS X-rays were 155.1 ± 29.7 in the traditional technique (n = 14), 143.0 ± 43.2 in the drill and joystick technique (n = 22), and 85 ± 18.7 in the K-wires first technique (n = 17), p = < 0.001 using one-way ANOVA. CONCLUSIONS The K-wire first technique statistically significantly decreases X-ray IS numbers p ≤ 0.001. There were no statistically significant differences between the traditional (after osteotomy K-wire placement) and the drill and joystick techniques (p = 0.36).
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Affiliation(s)
- Abraham Guadalupe Espinosa-Uribe
- Human Anatomy Department, School of Medicine, Universidad Autónoma de Nuevo León, Avenida Francisco I. Madero y Gonzalitos S/N Colonia Mitras Centro, Monterrey, Nuevo León, 64460, México
| | - Fernando A Fernández-Garza
- Instituto de Seguridad Social de Trabajadores del Estado de Nuevo León (ISSSTELEON), Monterrey, Nuevo León, México
| | - David Muñoz-Leija
- Human Anatomy Department, School of Medicine, Universidad Autónoma de Nuevo León, Avenida Francisco I. Madero y Gonzalitos S/N Colonia Mitras Centro, Monterrey, Nuevo León, 64460, México.
| | - José Félix Vílchez-Cavazos
- Human Anatomy Department, School of Medicine, Universidad Autónoma de Nuevo León, Avenida Francisco I. Madero y Gonzalitos S/N Colonia Mitras Centro, Monterrey, Nuevo León, 64460, México
- Universidad Autónoma de Nuevo León, Orthopedics and Traumatology Service, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Monterrey, México
| | - Alejandro Quiroga-Garza
- Human Anatomy Department, School of Medicine, Universidad Autónoma de Nuevo León, Avenida Francisco I. Madero y Gonzalitos S/N Colonia Mitras Centro, Monterrey, Nuevo León, 64460, México
- Instituto Mexicano del Seguro Social, Hospital de Traumatología y Ortopedia #21, Monterrey, Nuevo León, México
| | - Víctor M Peña-Martínez
- Universidad Autónoma de Nuevo León, Orthopedics and Traumatology Service, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Monterrey, México
| | - Rodrigo E Elizondo-Omaña
- Human Anatomy Department, School of Medicine, Universidad Autónoma de Nuevo León, Avenida Francisco I. Madero y Gonzalitos S/N Colonia Mitras Centro, Monterrey, Nuevo León, 64460, México
| | - Jorge Gutiérrez-de la O
- Human Anatomy Department, School of Medicine, Universidad Autónoma de Nuevo León, Avenida Francisco I. Madero y Gonzalitos S/N Colonia Mitras Centro, Monterrey, Nuevo León, 64460, México
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Ferreira GF, Nunes GA, Pugliese GM, Dinato MCME, Lewis TL, Sato G, Pedroso JP, Filho MVP. Minimally invasive Chevron-Akin (MICA) osteotomies without Akin fixation in hallux valgus correction: a case series with 2-year follow-up. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2024; 34:2339-2345. [PMID: 38583122 DOI: 10.1007/s00590-024-03924-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 03/17/2024] [Indexed: 04/08/2024]
Abstract
PURPOSE The minimally invasive Chevron-Akin (MICA) is considered the third generation of minimally invasive hallux valgus (HV) surgery, and its original description included fixation of the Akin osteotomy with a screw. The aim of this study is to evaluate a series of patients undergoing HV correction using the MICA technique without screw fixation of the Akin osteotomy. METHODS We retrospectively evaluated 58 consecutive patients who underwent surgical correction for HV between August 2018 and March 2020. A total of 69 feet were evaluated with a minimum follow-up of 2 years. Clinical outcomes such as pain (VAS), function (AOFAS), range of movement, criteria personal satisfaction and complications were evaluated. RESULTS The AOFAS score (mean ± standard deviation) significantly improved from 57.0 ± 8.6 preoperatively to 93.9 ± 8.7 postoperatively (p < .001) with a minimum follow-up of 2 years. The VAS score improved from 6.0 ± 1.8 preoperatively to 0.6 ± 1.4 at 2-year follow-up (p < .001), and the hallux valgus angle reduced from 39.7 ± 6.9 to 8.9 ± 9.0 (p < .001). The majority of patients (95.6%) reported the result as excellent or good, and the most common complication was the need to remove the screw (7.2%). CONCLUSIONS The use of MICA without Akin osteotomy fixation resulted in successful correction of hallux valgus with improvements in clinical and radiographic parameters. LEVEL OF EVIDENCE IV, case series.
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Affiliation(s)
- Gabriel Ferraz Ferreira
- Orthopaedics and Traumatology Unit, Foot and Ankle Surgery Group, Prevent Senior, São Paulo, Brazil
- Instituto Vita, São Paulo, Brazil
- Member of Minimally Invasive Foot Ankle Society (MIFAS By GRECMIP), Merignac, France
| | - Gustavo Araujo Nunes
- Member of Minimally Invasive Foot Ankle Society (MIFAS By GRECMIP), Merignac, France
- Foot and Ankle Unit, COTE Brasília Clinic, Brasília, DF, Brazil
| | | | | | | | | | - João Paulo Pedroso
- Orthopaedics and Traumatology Unit, Foot and Ankle Surgery Group, Prevent Senior, São Paulo, Brazil
| | - Miguel Viana Pereira Filho
- Instituto Vita, São Paulo, Brazil.
- Orthopaedics and Traumatology Unit, Head of Foot and Ankle Surgery Group, Prevent Senior, São Paulo, Brazil.
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Mazzotti A, Zielli SO, Giacomo C, Artioli E, Arceri A, Abdi P, Langone L, Faldini C. Combined Distal Metatarsal and Akin Osteotomies for Concomitant Metatarsophalangeal and Interphalangeal Hallux Valgus: Clinical and Radiological Outcomes. J Foot Ankle Surg 2024; 63:366-371. [PMID: 38218344 DOI: 10.1053/j.jfas.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/08/2023] [Accepted: 01/06/2024] [Indexed: 01/15/2024]
Abstract
Combined metatarsal and Akin-type proximal phalanx osteotomies represent a surgical solution for concomitant metatarso-phalangeal and inter-phalangeal hallux valgus. This retrospective observational study aimed to evaluate clinical and radiographic outcomes following combined distal linear metatarsal and Akin osteotomies. The study included 42 feet from 37 patients, with a mean follow-up of 27.1 (range 24-37) months. Mean surgical time was 16.54 ± 4.17 minutes. Pre- and postoperative clinical scores and radiological parameters were collected. Positive outcomes with a low recurrence and complications rates were reported. A statistically significant improvement in the Manchester-Oxford foot questionnaire, the EuroQol 5D-5L dimensions instrument, the visual analogue scale, the intermetatarsal angle, the hallux valgus angle, the distal metatarsal articular angle, and the interphalangeal angle correction was observed. Despite the results reported, further prospective studies are needed to identify the most suitable patients for this combined osteotomy approach.
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Affiliation(s)
- Antonio Mazzotti
- IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatologic Clinic, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Simone Ottavio Zielli
- IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatologic Clinic, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy.
| | - Casadei Giacomo
- IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatologic Clinic, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Elena Artioli
- IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatologic Clinic, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Alberto Arceri
- IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatologic Clinic, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Pejman Abdi
- IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatologic Clinic, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Laura Langone
- IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatologic Clinic, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Cesare Faldini
- IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatologic Clinic, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Beischl S, Harrasser N, Toepfer A, Scheele C, Smits Sererna R, Walther M, Lenze F, Hörterer H. Feasibility and safety of minimally invasive calcaneal osteotomy (MICO) through a medial approach: a case-control study. ORTHOPADIE (HEIDELBERG, GERMANY) 2024; 53:39-46. [PMID: 38078936 PMCID: PMC10781868 DOI: 10.1007/s00132-023-04460-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 01/11/2024]
Abstract
INTRODUCTION Minimally invasive calcaneal osteotomy (MICO) is already an established surgical procedure for correcting hindfoot deformities using a lateral approach. So far, no description of a medial approach for MICO has been published. MATERIAL AND METHODS Between August 2022 and March 2023, 32 consecutive patients (MICO with medial approach, MMICO: n = 15; MICO with lateral approach, LMICO: n = 17) underwent MICO as part of complex reconstructive surgery of the foot and ankle with concomitant procedures. The amount of correction in the axial view of the calcaneus and consolidation rates were evaluated radiographically. Subjective satisfaction, stiffness of the subtalar joint, and pain level (numeric rating scale, NRS) at the level of the heel were assessed clinically. The last follow-up was at 6 months. RESULTS All osteotomies consolidated within 6 months after surgery. Displacement of the tuber was 9 mm on average in either group. Relevant subtalar joint stiffness was detected in 5 MMICO and 6 LMICO patients. No relevant differences between the groups were detected for wound healing problems, nerve damage, heel pain or patient satisfaction. CONCLUSION In this study lateral and medial approaches for MICO were performed. Similar degrees of correction and low complication rates were found in both groups. The medial approach for MICO is safe and can be beneficial regarding patient positioning and arrangement of the C‑arm.
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Affiliation(s)
- S Beischl
- Clinic of Orthopaedics, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - N Harrasser
- Clinic of Orthopaedics, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany.
| | - A Toepfer
- Orthopaedics and Traumatology, Kantonsspital St. Gallen, Rorschacher Straße 95, 9007, St. Gallen, Switzerland
| | - C Scheele
- Clinic of Orthopaedics, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - R Smits Sererna
- Clinic of Orthopaedics, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - M Walther
- Center for Foot and Ankle Surgery, Schön Clinic Munich Harlaching - FIFA Medical Centre, Harlachinger Straße 51, 81547, Munich, Germany
| | - F Lenze
- Clinic of Orthopaedics, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - H Hörterer
- Center for Foot and Ankle Surgery, Schön Clinic Munich Harlaching - FIFA Medical Centre, Harlachinger Straße 51, 81547, Munich, Germany
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany
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Palmanovich E, Ohana N, Tavdi A, Atzmon R, Feldman V, Brin YS, Nyska M, Segal D. A modified minimally invasive osteotomy for hallux valgus enables reduction of malpositioned sesamoid bones. Arch Orthop Trauma Surg 2023; 143:6105-6112. [PMID: 37202550 DOI: 10.1007/s00402-023-04868-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 03/26/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND The current minimally invasive distal metatarsal osteotomy for hallux valgus (HV) is V-shaped, which prevents the correction of the rotational metatarsal head deformity and reduction of the sesamoid bones. We sought to determine the optimal method for sesamoid bone reduction during HV surgery. METHODS We reviewed the medical records of 53 patients who underwent HV surgery between 2017 and 2019 using one of three techniques: open chevron osteotomy (n = 19), minimally invasive V-shaped osteotomy (n = 18), and a modified straight minimally invasive osteotomy (n = 16). The sesamoid position was graded using the Hardy and Clapham method on weight-bearing radiographs. RESULTS When compared to open chevron and V-shaped osteotomies, the modified osteotomy resulted in significantly lower postoperative sesamoid position scores (3.74 ± 1.48, 4.61 ± 1.09, and 1.44 ± 0.81, respectively, P < 0.001). Furthermore, the mean change in postoperative sesamoid position score was greater (P < 0.001). CONCLUSION The modified minimally invasive osteotomy was superior to the other two techniques in correcting HV deformity in all planes, including sesamoid reduction.
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Affiliation(s)
- Ezequiel Palmanovich
- Orthopaedic Department, Meir Hospital, Sapir Medical Center, Kfar Saba, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 56 Tchernichovsky St., 4428164, Kfar Saba, Israel.
| | - Nissim Ohana
- Orthopaedic Department, Meir Hospital, Sapir Medical Center, Kfar Saba, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 56 Tchernichovsky St., 4428164, Kfar Saba, Israel
| | - Alex Tavdi
- Orthopaedic Department, Meir Hospital, Sapir Medical Center, Kfar Saba, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 56 Tchernichovsky St., 4428164, Kfar Saba, Israel
| | - Ran Atzmon
- Assuta Medical Center, Department of Orthopaedic Surgery, Affiliated with the Faculty of Health and Science and Ben Gurion University, 7747629, Ashdod, Israel
| | - Viktor Feldman
- Orthopaedic Department, Meir Hospital, Sapir Medical Center, Kfar Saba, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 56 Tchernichovsky St., 4428164, Kfar Saba, Israel
| | - Yaron S Brin
- Orthopaedic Department, Meir Hospital, Sapir Medical Center, Kfar Saba, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 56 Tchernichovsky St., 4428164, Kfar Saba, Israel
| | - Meir Nyska
- Orthopaedic Surgery Specialist, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Segal
- Orthopaedic Department, Meir Hospital, Sapir Medical Center, Kfar Saba, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 56 Tchernichovsky St., 4428164, Kfar Saba, Israel
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Nunes GA, de Carvalho KAM, Ferreira GF, Filho MVP, Baptista AD, Zambelli R, Vega J. Minimally invasive Chevron Akin (MICA) osteotomy for severe hallux valgus. Arch Orthop Trauma Surg 2023; 143:5507-5514. [PMID: 36977832 DOI: 10.1007/s00402-023-04849-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/15/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION The minimally invasive Chevron Akin (MICA) osteotomy has been widely used to treat hallux valgus (HV). The purpose of this study was to present a case series of patients with severe HV undergoing surgical treatment using the MICA procedure and to evaluate the clinical and radiographic outcomes. MATERIALS AND METHODS Retrospective study including 60 consecutive feet (52 patients) undergoing MICA for severe HV. The data were collected pre- and post-operatively at the last follow-up. Patients were clinically evaluated by the visual analog pain scale (VAS) and AOFAS hallux MTP-IP score. Radiographic assessments included measurements of hallux valgus angle (HVA), intermetatarsal angle (IMA), metatarsal (MT) length, distal metatarsal articular angle (DMAA), and plantar translation of MT head. The complications were recorded during the follow-up. RESULTS The mean age was 59.9 years, and the mean follow-up was 20.5 months. The average AOFAS increased from 41.2 to 90.9 points, and the VAS from 8.1 to 1.3 at the last follow-up. The average HVA decreased from 41.2º to 11.6º, the IMA from 17.1º to 6.9º, and the DMAA from 17.9º to 7.8º. The average shortening of the first metatarsal and the plantar translation of the MT head was 5.1 mm and 2.8 mm, respectively. The most observed complication was hardware discomfort, observed in 5 feet (8.3%). There were two cases of recurrence (3.3%). CONCLUSION MICA technique was demonstrated in this series of cases to be an effective procedure for severe HV, with a low rate of recurrence and an acceptable rate of complications. LEVEL OF EVIDENCE IV; case series.
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Affiliation(s)
- Gustavo Araujo Nunes
- MIFAS by GRECMIP: Minimally Invasive Foot and Ankle Society, Merignac, France.
- COTE Brasília Clinic, Foot and Ankle Unit, Brasília, DF, Brazil.
- SGAS, 915 Lote 68a Salas 16/17 Centro Clínico Advance 2 - Asa Sul, Brasília, DF, 70390-150, Brasil.
| | - Kepler Alencar Mendes de Carvalho
- Department of Orthopedics and Rehabilitation, University of Iowa, Carver College of Medicine, Iowa City, IA, USA
- Nossa Senhora do Pari Beneficent Association, São Paulo, SP, Brazil
| | - Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
- Instituto Vita, São Paulo, Brazil
| | - Miguel Viana Pereira Filho
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
- Instituto Vita, São Paulo, Brazil
| | | | | | - Jordi Vega
- MIFAS by GRECMIP: Minimally Invasive Foot and Ankle Society, Merignac, France
- Laboratory of Arthroscopic and Surgical Anatomy, Department of Pathology and Experimental Therapeutics (Human Anatomy Unit), University of Barcelona, Barcelona, Spain
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Lewis TL, Lau B, Alkhalfan Y, Trowbridge S, Gordon D, Vernois J, Lam P, Ray R. Fourth-Generation Minimally Invasive Hallux Valgus Surgery With Metaphyseal Extra-Articular Transverse and Akin Osteotomy (META): 12 Month Clinical and Radiologic Results. Foot Ankle Int 2023; 44:178-191. [PMID: 36788732 DOI: 10.1177/10711007231152491] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
BACKGROUND Fourth-generation minimally invasive surgery (MIS) includes the multiplanar rotational deformity correction achieved through manipulation of an extra-articular distal first metatarsal osteotomy that is held with rigid fixation using 2 fully threaded screws, of which one must be bicortical to provide rotational and biomechanical stability. The aim of this study is to report the clinical and radiologic outcomes of an evolved fourth-generation MIS hallux valgus technique. METHODS A prospective single-surgeon series of consecutive patients undergoing fourth-generation MIS was performed using a distal transverse osteotomy with a minimum 12-month follow-up. The primary outcome was the Manchester-Oxford Foot Questionnaire (MOXFQ), a validated clinical patient-reported outcome measure (PROM). Secondary outcomes included radiographic deformity correction, clinical assessment, and EuroQol-5D-5L PROMs. RESULTS Between September 2019 and June 2021, 50 feet underwent fourth-generation MIS. The mean age was 55.8±15.3 years with a mean follow-up of 1.4 years. Preoperative and minimum 12-month primary outcome data were available for 100% of feet. There was a significant improvement in all MOXFQ domain scores, with the index domain improving from 53.4 to 13.1 (P < .001). There was a significant improvement (P < .001) in hallux valgus angle (32.7 to 7.9 degrees), intermetatarsal angle (14.0 to 4.2 degrees) and distal metatarsal articular angle (18.5 to 5.6 degrees). There was a significant improvement in general health-related quality of life EQ-5D-5L index and EQ-VAS scores (P < .05). CONCLUSION The fourth-generation MIS technique is a safe and effective approach to hallux valgus deformity correction with significant improvement in clinical and radiographic outcomes. LEVEL OF EVIDENCE Level IV, prospective case series.
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Affiliation(s)
- Thomas L Lewis
- King's Foot and Ankle Unit, King's College Hospital NHS Foundation Trust, United Kingdom
| | - Benjamin Lau
- King's Foot and Ankle Unit, King's College Hospital NHS Foundation Trust, United Kingdom
| | - Yousif Alkhalfan
- Guy's and St Thomas' NHS Foundation Trust, Maze Pond, London, United Kingdom
| | - Samuel Trowbridge
- King's Foot and Ankle Unit, King's College Hospital NHS Foundation Trust, United Kingdom
| | | | - Joel Vernois
- Institut de Chirurgie du Pied (ICP), Clinique Blomet, Paris, France
| | - Peter Lam
- Orthopaedic and Arthritis Specialist Centre, Chatswood, Sydney, Australia
| | - Robbie Ray
- King's Foot and Ankle Unit, King's College Hospital NHS Foundation Trust, United Kingdom
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