Minimally invasive Akin osteotomy and lateral release: Anatomical structures at risk—A cadaveric study

Arauz, Juan Manuel Yañez; Vecchio, Jorge Javier Del; Codesido, Mariano; Raimondi, Nicolás

doi:10.1016/j.foot.2016.03.003

Cited by 20 publications

(8 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, 3 systematic reviews concluded that MIS is safe and reliable for hallux valgus surgery. 4,9,31 Four cadaveric studies deemed percutaneous forefoot surgery a safe technique when it is performed by experienced surgeons, 13,21,43,48 which agrees with clinical studies.…”

supporting

confidence: 70%

“…Nevertheless, tendon lesions seem more frequent if an Akin osteotomy is performed. 48 No tendon lesions were found in this study; however, the tendons are at higher risk of being injured if they are in tension against the burr. The EHL is especially at risk while performing the dorsal portion of the PeICO.…”

Section: Discussionmentioning

confidence: 50%

“…The DMDN and dorsomedial digital nerve (DLDN) 13,48 are at risk during percutaneous forefoot surgery. Although nerve injury may not produce representative symptoms, neuroma generation may have a higher impact on patient satisfaction and may require revision procedures.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Percutaneous, Intra-articular, Chevron Osteotomy (PeICO) for the Treatment of Hallux Valgus: A Cadaveric Study

Vecchio

Ghioldi

Uzair³

et al. 2019

Foot Ankle Int.

Self Cite

View full text Add to dashboard Cite

Background: Percutaneous surgery is experiencing sustained growth based on third-generation techniques. This cadaveric study was designed with the main goal of exploring the risk of iatrogenic tendon and neurovascular lesions and defining the safe zones in a percutaneous, intra-articular, chevron osteotomy (PeICO) procedure, as well as assessing the accuracy of the osteotomy itself. Methods: Eight feet from below-knee fresh-frozen specimens were selected. After the procedure, the specimens were dissected, and structures were inspected for damage. Results: The results of the safety measurements were as follows: (1) distance between portal 1 (P1) and the lateral border of the extensor hallucis longus (EHL) tendon: average 17.6 mm (range 12.7-21.3); (2) distance between P1 and the dorsomedial digital nerve (DMDN): average 7.2 mm (range 1.6-10.4); (3) distance between P1 and the metatarsophalangeal joint: average 15.7 mm (range 9.4-20.5); distance between portal 2 (P2), or the osteosynthesis portal, and the metatarsophalangeal joint: average 25.5 mm (range 22-30.4); distance between P2 and the lateral border of the EHL tendon: average 12.7 mm (range 8-16.7); and distance between P2 and the DMDN: average 4.1 mm (range 1.7-8.2). There were no iatrogenic injuries. The osteotomy angulation in the sagittal plane (reproducibility) average was 85.6 degrees. Conclusion: There were no iatrogenic injuries on this cadaveric study of PeICO. Clinical Relevance: This study will help orthopedic surgeons understand the risks of performing percutaneous surgery by mimicking an accepted open technique (chevron).

show abstract

supporting

confidence: 70%

Section: Discussionmentioning

confidence: 50%

See 1 more Smart Citation

Percutaneous, Intra-articular, Chevron Osteotomy (PeICO) for the Treatment of Hallux Valgus: A Cadaveric Study

Vecchio

Ghioldi

Uzair³

et al. 2019

Foot Ankle Int.

Self Cite

View full text Add to dashboard Cite

show abstract

“…Dorsal nerves can be injured when approaching the dorsal aspect of the first MTP joint. Recently, Yañez Arauz et al 40 showed that a high risk of nerve injury is present when the LR is made through the dorsal-lateral portal, near the extensor hallucis longus tendon. They observed an average distance between this dorsal approach and the dorsolateral digital nerve of 0.7 mm.…”

Section: Discussionmentioning

confidence: 99%

Anatomical Study of Minimally Invasive Lateral Release Techniques for Hallux Valgus Treatment

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: Lateral release (LR) for the treatment of hallux valgus is a routinely performed technique, either by means of open or minimally invasive (MI) surgery. Despite this, there is no available evidence of the efficacy and safety of MI lateral release. Our aim was to study 2 popular techniques for MI LR in cadavers by subsequently dissecting the released anatomical structures. Methods: Twenty-two cadaveric feet were included in the study and allocated into 2 groups, 1 for each procedure: 1 group underwent a MI adductor tendon release (AR), and in the other group, an extensive percutaneous lateral release (EPLR) (adductor tendon, suspensory ligament, phalanx-sesamoid ligament, lateral head of flexor hallucis brevis, and deep transverse metatarsal ligament) was performed. Anatomical dissection was performed to identify neurovascular injuries and to verify the released structures. Results: Both techniques demonstrated to be effective in reproducing a MI LR. A satisfactory release of the adductor tendon was achieved equally in both techniques ( P = .85), being partial in most EPLR cases and full in the majority of AR cases. The EPLR was successful in releasing the intended additional structures ( P < .05). One case of inadvertent complete section of the flexor hallucis longus was identified in the percutaneous adductor tendon release group. No cases of dorsolateral nerve injury were seen with either of the techniques. Conclusion: Percutaneous lateral release was a reliable and accurate technique in this cadaveric model. The MI AR proved to be more effective in fully releasing the adductor tendon while the ER was intended and able to release a number of other structures. Clinical Relevance: MI LR is a safe procedure that could obviate the need for open surgery to achieve the same surgical goal. It can be associated to either open or MI osteotomies in the correction of hallux valgus.

show abstract

“…Some of them may be related to studies that have measured the distance between minimally invasive surgery (MIS) portals and anatomical structures. 2,4,5,9 Thus, surgeons can more accurately assess the risk of injury, especially in small neurologic structures.…”

mentioning

confidence: 99%

Letter Regarding: Minimally Invasive Dorsal Cheilectomy of the First Metatarsal: A Cadaveric Study / Clinical Outcomes Following Minimally Invasive Dorsal Cheilectomy for Hallux Rigidus

Vecchio¹,

Laffenêtre²,

Dealbera³

et al. 2019

Foot Ankle Int.

Self Cite

View full text Add to dashboard Cite

Minimally invasive Akin osteotomy and lateral release: Anatomical structures at risk—A cadaveric study

Cited by 20 publications

References 4 publications

Percutaneous, Intra-articular, Chevron Osteotomy (PeICO) for the Treatment of Hallux Valgus: A Cadaveric Study

Percutaneous, Intra-articular, Chevron Osteotomy (PeICO) for the Treatment of Hallux Valgus: A Cadaveric Study

Anatomical Study of Minimally Invasive Lateral Release Techniques for Hallux Valgus Treatment

Letter Regarding: Minimally Invasive Dorsal Cheilectomy of the First Metatarsal: A Cadaveric Study / Clinical Outcomes Following Minimally Invasive Dorsal Cheilectomy for Hallux Rigidus

Contact Info

Product

Resources

About