Minimally invasive technique with intramedullary nail for treatment of severe hallux valgus

Abstract

Objective: The purpose of the study was to evaluate early clinical and radiological results with a novel minimally invasive surgery (MIS) technique for Lapidus arthrodesis using intramedullary nail. Methods: Retrospective review of patients with hallux valgus surgery during an 18-month period. Patients with a procedure other than MIS Lapidus nail fixation were excluded. We describe surgical technique with a percutaneous joint preparation and fixation with an intramedullary nail through a MIS approach. Demographic variables, early complications and radiographic parameters were measured. Results: Ten feet in 8 patients with severe HV underwent a Lapidus procedure performed with a minimal invasive technique using intramedullary nail for fixation. No soft tissue complications and 1 patient required screw removal after bone healing. Mean HVA decreased from 31,4 degrees (range 17 to 47) SD (±9,3) to 10,3 degrees (range, -8,8 to 31,5) SD (±8,4), mean IMA decreased from 17,91 degrees (range, -17 to 20) SD (±0,9) to 5,46 degrees (range, –7,3 to 15.3) SD (±2,9) and mean DMAA decreased from 20,36 (range, 10-40) SD (±8,4) to 7,67 (range, -5 to 30) SD (±8,0). Conclusion: Intramedullary nail for Lapidus arthrodesis with minimally invasive technique showed satisfactory radiographic correction and minimal complications, but further follow up is needed to analyze clinical-radiographic results. Level of Evidence IV; Therapeutic Study; Case Series.

Minimally invasive Chevron-Akin osteotomy

“…The combination of a stable and rigid internal fixation combined with a minimally invasive approach revolutionized percutaneous HV treatment (10,11) and, as a result, has become very J Foot Ankle. 2020;14(3):264-8 popular with foot and ankle surgeons for HV repair (11) .…”

“…The combination of a stable and rigid internal fixation combined with a minimally invasive approach revolutionized percutaneous HV treatment (10,11) and, as a result, has become very J Foot Ankle. 2020;14(3):264-8 popular with foot and ankle surgeons for HV repair (11) . While there are some studies demonstrating the promising results of the MICA technique (12)(13)(14) , there is still a lack of scientific evidence proving its superiority over traditional procedures (11) .…”

“…2020;14(3):264-8 popular with foot and ankle surgeons for HV repair (11) . While there are some studies demonstrating the promising results of the MICA technique (12)(13)(14) , there is still a lack of scientific evidence proving its superiority over traditional procedures (11) . Moreover, some authors still question the procedure's advantages and reproducibility (15) .…”