A Retrospective Study of 63 Hallux Valgus Corrections Using the Osteodesis Procedure

Can the Syndesmosis Procedure Prevent Metatarsus Primus Varus and Hallux Valgus Deformity Recurrence? A 5-Year Prospective Study

“…The syndesmosis procedure was originally called the osteodesis of the first metatarsal when it was first reported in 1961 (21). Favorable results have since been documented (22)(23)(24)(25)(26); however, it is still largely undiscovered and unrecognized by most surgeons (27). The purpose of the present study was to confirm the effectiveness of intermetatarsal cerclage sutures in the initial correction of MPV and HV deformities and to conduct a medium long-term radiologic followup study of the syndesmosis concept for first metatarsal restabilization and deformity recurrence prevention.…”

“…An initial 1-in. incision was made along the distal dorsal medial border of the second metatarsal (22)(23)(24)(25)(26). After blunt dissection, the interosseous muscle was retracted laterally and partially resected if necessary to help expose the lateral soft tissue structures for release of the lateral collateral and metatarsosesamoid ligaments.…”

Use of 3D Printed Bone Plate in Novel Technique to Surgically Correct Hallux Valgus Deformities

“…Today, a variety of devices, mostly suture buttons, are available. Unlike many osteotomy and Lapidus fusion procedures that require longer recovery to allow for bone healing, tethering approaches allow patients to weight-bear sooner, within 1–2 weeks [4, 6]. Though less obvious, tethering procedures can also control the hypermobility of the first ray in both the sagittal and transverse planes by having the “pseudoligament” created with the suture material between the first and second metatarsals restrict the first metatarsal dorsiflexion and splaying in the transverse plane.…”

“…Though less obvious, tethering procedures can also control the hypermobility of the first ray in both the sagittal and transverse planes by having the “pseudoligament” created with the suture material between the first and second metatarsals restrict the first metatarsal dorsiflexion and splaying in the transverse plane. While successful long-term outcomes have been reported [6, 43], current tethering procedures are not without their own challenges, mostly related to the stresses placed on the second metatarsal by the tether itself [5]. For example, a suture button construct requires a drill hole through the second metatarsal, which can become a stress concentrator.…”

“…In fact, the lack of consensus continues to promote surgical innovation, particularly in the fields of materials science and mechanical engineering. Modern techniques involving tethering a suture-button or suture cerclage, offer less invasive bone and joint sparing correction approaches, but these procedures place large stresses on the second metatarsal and consequently have introduced additional complications such as second metatarsal fracture [4– 6]. Here, we describe the design and use of a 3-D printed titanium alloy (Ti-6Al-4V ELI) plate that is placed on the second metatarsal and addresses the challenges with current joint sparing approaches.…”