Endolog technique for correction of hallux valgus: a prospective study of 30 patients with 4-year follow-up

Abstract

BackgroundHallux valgus (HV) is a complex deformity of the forefoot altering the kinematics of walking. Many different treatment alternatives exist for the correction of hallux valgus, but to date, none has been shown to be more effective than any other. The rate of complications following hallux valgus surgery is variable and has been reported as ranging from 1 to 55 % in the scientific literature. The purpose of this preliminary prospective study was to evaluate the result of the Endolog device, an innovative titanium endomedullary nail, for the treatment of HV.MethodsThirty patients with mild-to-severe HV were treated with the Endolog device. Clinical evaluation was assessed preoperatively, as well as at 3, 6, 12, 24, and 48 months after surgery with a final follow-up at 4 years, using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux grading system. Computer-assisted measurement of weight-bearing antero-posterior radiographs was taken preoperatively and postoperatively, as well as at 3, 6, 12, 24, and 48 months after surgery. Non-weight-bearing radiographs were taken before the patients were discharged. The radiological parameters measured included the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA), and the tibial sesamoid position. Statistical analysis was carried out using the paired t test (p < 0.05).ResultsThe mean AOFAS score was 93.98 points at the 48-month follow-up. The postoperative radiographic assessments showed a statistically significant improvement compared with preoperative values. The mean corrections for each angular value at the last follow-up were as follows: IMA 5.95°; HVA 16.81°; DMAA 10.70°; and tibial sesamoid 1.36°.ConclusionThe Endolog is a safe and effective technique for the correction of HV deformity, to relieve pain and to preserve joint movement.

Medium-Long-Term Clinical and Radiographic Outcomes of Minimally Invasive Distal Metatarsal Metaphyseal Osteotomy (DMMO) for Central Primary Metatarsalgia: Do Maestro Criteria Have a Predictive Value in the Preoperative Planning for This Percutaneous Technique?

“…In a second step, associated deformities, when present, were assessed and then corrected during the same operation. Surgical procedures on the first ray were performed according to our institutional protocol: HV correction by Reverdin-Isham percutaneous osteotomy for mild-moderate deformity, or Endolog technique for moderate-severe deformity, both generally followed by percutaneous Akin osteotomy [29, 34]. In addition, percutaneous lateral soft-tissue release and percutaneous tenotomy of extensor and/or flexor, in association with (or not) phalange percutaneous osteotomies, were tailored based on the lesser toe deformities, flexible or fixed.…”

Functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with Reverdin-Isham and Akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up

“…Painful HV is more frequent in women between 40 and 60 years old, although it can appear in younger people because of biomechanical influence, hind and midfoot pathologies or sports activities, which might cause an overload on the first ray [2, 3]. For its correction, a wide variety of bony procedures are described, associated or not with soft tissue release, including osteotomies at the level of the head, midshaft and base of the first metatarsal, as well as arthrodesis of the first metatarso-cuneiform joint [4–7]. This demonstrates the complexity of the disease and the lack of a unique and most appropriate treatment, the choice of which continues to generate controversy [8].…”

Eficacia de las técnicas quirúrgicas en el Hallux Abductus Valgus mediante aplicación de escala de la American Orthopedic Foot and Ankle Society: Revisión bibliográfica

“…Por otro lado, la técnica endológica mediante abordaje abierto, es la técnica que más ha escalado en la AOFAS con un total de 65,2, un valor inicial de 28,7 y final de 93,80 (8).…”