Percutaneous hallux valgus surgery: Comparison between mini-invasive Chevron and Bosch osteotomies

Carlucci, Sofia; Araujo, Maria Gala Santini; Conti, Leonardo; Villena, Daniel Sebastián; Parise, Ana Cecilia; Carrasco, Nelly; Sotelano, Pablo

doi:10.1016/j.recote.2020.09.006

Cited by 4 publications

(4 citation statements)

References 25 publications

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“…The procedure was performed bilaterally and simultaneously in 18 patients (31.5%). Twenty-two feet (29.8%) had isolated fifth S-DMMO, whereas 52 feet (70.2%) had additional procedures: 22 (29.8%) needed a modified Bosch 3 procedure and 15 feet (20.2%) a percutaneous, intra-articular, chevron osteotomy 11 technique to treat hallux valgus. Other percutaneous procedures indicated were as follows: 7 feet (9.4%) required a percutaneous Akin osteotomy 57 of the proximal phalanx of the first toe; 6 feet (8.1%) needed a DMMO of second-to-fourth metatarsals 20 because of central metatarsalgia; and 2 (2.7%) required a percutaneous procedure for lesser toe deformities.…”

Section: Resultsmentioning

confidence: 99%

Midterm Outcomes of Sliding Distal Metatarsal Minimally Invasive Osteotomy to Treat Bunionette Deformity

et al. 2022

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Background: Bunionette deformity is described as a painful bony prominence on the lateral aspect of the fifth metatarsal head. The present study prospectively assessed the clinical, functional, and radiographic outcomes of sliding distal metatarsal minimally invasive osteotomy (S-DMMO) used in a large series of patients with a midterm follow-up period. Methods: From December 2015 to December 2018, we evaluated 74 feet (57 patients). Radiologic (4-to-5 intermetatarsal angle, fifth metatarsophalangeal angle, the fifth metatarsal head width, lateral deviation angle, fifth metatarsal length, medial displacement, and elevation), clinician-reported scores (AOFAS score, visual analog scale [VAS]) and patient-reported outcomes measure (Foot and Ankle Ability Measure [FAAM] activities of daily living [ADL], FAAM sports, Manchester-Oxford Foot Questionnaire [MOXFQ], and patient satisfaction survey) were included in the analysis. The time to bone union was also assessed. Results: The average 4-to-5 intermetatarsal angle improved from 11.1 degrees preoperatively to 4.5 degrees postoperatively ( P < .001), whereas the average fifth metatarsophalangeal angle improved from 15.7 degrees preoperatively to 4.8 degrees postoperatively ( P < .001). The lateral deviation angle was found to be 2.2 degrees. The fifth metatarsal length decreased from 66.6 to 64.3 mm postoperatively. The average initial medial displacement was 4.67 mm preoperatively and 4.54 mm at final follow-up. The elevation of the fifth metatarsal head was 1.08 mm. The American Orthopaedic Foot & Ankle Society score improved from 54.3 ± 20.86 points preoperatively to 93.4 ± 17.3 ( P < .001). VAS score decreased from 7.9 to 0.7 ( P < .001). Also, FAAM ALD, FAAM Sport, and MOXFQ showed statistically significant differences ( P < .001) between preoperative and postoperative periods. Patients found the procedure excellent in 89.1% of cases, very good in 5.4%, and good in 5.4%. Bone union was obtained at 8.1 weeks. Conclusion: The most important finding of the present study is that S-DMMO showed improvement in function and pain associated with a high satisfaction rate. Also, we found substantial capacity to correct deformities and a low incidence of complications. Level of Evidence: Level IV, case series.

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Section: Resultsmentioning

confidence: 99%

Midterm Outcomes of Sliding Distal Metatarsal Minimally Invasive Osteotomy to Treat Bunionette Deformity

et al. 2022

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“…The radiological screen time was significantly longer for the MIS group. This result could be due to the fact that the MIS technique is more demanding than the open Chevron osteotomy and may also influence the surgical time, depending on the surgeon's experience with the surgical technique, -which has also been described by other reports [47,48].…”

Section: Discussionmentioning

confidence: 80%

Percutaneous Chevron Osteotomy: A Prospective Randomized Controlled Trial

Dragosloveanu

Popov

Cotor³

et al. 2022

Medicina

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Introduction: Minimally invasive surgical techniques for hallux valgus have gained popularity, showing good results characterized by smaller postoperative scars, less pain, lower infection risk, and fewer wound complications. Given the lack of evidence available in our country regarding this subject, especially about this type of surgical technique, our paper aims to compare open and MIS approaches for chevron osteotomy. We evaluated the outcome and complications after 12 months. Materials and Methods: We undertook a prospective, randomized, controlled, single-center study between October 2017 and December 2020. The patients were randomized into two groups: one group that received percutaneous chevron osteotomy (MIS), and the other, open chevron osteotomy (OC). For clinical assessment, we determined the function and the level of pain using the Visual Analogue Scale (VAS) and The American Orthopaedic Foot and Ankle Surgery score (AOFAS). The VAS scale was measured before the surgical procedure, at discharge, and at 3 weeks, 6 weeks, 6 months, and 12 months after surgery. The AOFAS score was calculated preoperatively and after 6 months. The hallux angle (HVA) and intramedullary angle (IMA) were measured preoperatively, and at 6 weeks, 6 months and 12 months. Results: We included 26 cases in the open chevron osteotomy group (24 female, 2 male) and 24 in the MIS group (24 female, 0 male). Both groups demonstrated improvements regarding the IMA and HVA at the last follow-up without any significant differences between the groups at the final assessment. The VAS showed significantly better post-operative results for the MIS group at discharge (p < 0.001) and 3 weeks (p < 0.001), 6 weeks (p < 0.001), and 6 months (p = 0.004) post-surgery. The AOFAS showed no significant differences either before or after surgery. Four cases with screw prominence were reported, three of which belonged to the MIS group. Only one case with metatarsalgia was found in the OC group. Conclusions: This paper demonstrates that minimally invasive chevron osteotomy has comparable results with open chevron osteotomy, even though surgical time and radiological exposure are significantly longer. More studies are required to evaluate the complications and the risk of recurrences.

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“…This finding is in line with multiple studies that have compared the outcomes of a percutaneous technique and the open technique. 6 , 8 , 16 A randomized controlled trial performed by Kaufman et al 15 compared clinical and radiologic outcomes between minimally invasive vs open chevron osteotomies for hallux valgus surgery. They found no significant differences in any of the determined outcome measurements; however, their study size was relatively small.…”

Section: Discussionmentioning

confidence: 99%

MICA Procedure vs Open Chevron Osteotomy for Hallux Valgus Correction: A Prospective Cohort Study

Balesar,

Bruin,

van Liebergen

et al. 2024

Foot & Ankle Orthopaedics

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Background: Currently, more than 150 surgical techniques have been described for the treatment of hallux valgus. The abundance of techniques indicates that there is no technique that has been designated as a gold standard. In recent years, a particular interest in the use of minimally invasive techniques has grown. The aim of this study was to prospectively compare clinical, radiologic, and postoperative outcomes between the MICA technique and open chevron technique over a 1-year follow-up period. Methods: Between January 2016 and August 2020, data were prospectively collected from consecutive patients preoperatively and at 6 weeks, 3 months, and 12 months following minimally invasive chevron and Akin (MICA) or open chevron osteotomies. Radiographic outcomes were measured using weightbearing radiographs preoperatively and at 3 and 12 months postoperatively. Clinical outcomes were measured using the American Orthopaedic Foot & Ankle Society (AOFAS), Manchester-Oxford Foot Questionnaire (MOXFQ), VAS (visual analog scale), Foot Function Index (FFI), Foot and Ankle Outcome Score (FAOS), and Euro-QoL-5D (EQ5D) questionnaires. Results: Of the 68 patients, 42 patients (62%) underwent a MICA surgery and 26 patients (38%) underwent open chevron osteotomy. Both groups showed significant improvement in HVA, IMA, and DMAA at the 1-year follow-up. Our findings show that both clinical and radiologic outcomes of the MICA technique are comparable to the conventional open technique. No significant differences were found in clinical outcomes (VAS, AOFAS, MOXFQ, FFI, and FAOS), complication rate, and operative times. Conclusion: These results show that MICA is a safe alternative for chevron osteotomy. The clinical and radiologic outcomes of these 2 techniques by 12 months are comparable. Level of Evidence: Level II, prospective cohort study.

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Percutaneous hallux valgus surgery: Comparison between mini-invasive Chevron and Bosch osteotomies

Cited by 4 publications

References 25 publications

Midterm Outcomes of Sliding Distal Metatarsal Minimally Invasive Osteotomy to Treat Bunionette Deformity

Midterm Outcomes of Sliding Distal Metatarsal Minimally Invasive Osteotomy to Treat Bunionette Deformity

Percutaneous Chevron Osteotomy: A Prospective Randomized Controlled Trial

MICA Procedure vs Open Chevron Osteotomy for Hallux Valgus Correction: A Prospective Cohort Study

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