Short term results of osteotomy-sparing technique in management of moderate hallux valgus using TightRope system

ElAttar, Mohamed; Naggar, Ahmed El; Fahmy, Fahmy Samir; Mahmoud, Hossam Fathi

doi:10.1016/j.jor.2018.05.049

Cited by 4 publications

(5 citation statements)

References 9 publications

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“…According to the pathogenesis of the hallux valgus proposed by Perera et al (2011), the medial deviation of the first metatarsal came before the lateral deviation of the 1st phalanx. Therefore, some surgical interventions aimed to stabilize the first metatarsal using different techniques (Wong et al, 2014a;ElAttar et al, 2018). Our study found that the manifestation of the first metatarsal medial deviation induced by deforming load may be hindered by the forefoot abduction or pronation that formed a viscous cycle to provoke more deforming load.…”

Section: Discussionmentioning

confidence: 81%

Finite Element Analysis of Generalized Ligament Laxity on the Deterioration of Hallux Valgus Deformity (Bunion)

Wong

Yan

Chen

et al. 2020

Front. Bioeng. Biotechnol.

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Hallux valgus is a common foot problem affecting nearly one in every four adults. Generalized ligament laxity was proposed as the intrinsic cause or risk factor toward the development of the deformity which was difficult to be investigated by cohort clinical trials. Herein, we aimed to evaluate the isolated influence of generalized ligament laxity on the deterioration using computer simulation (finite element analysis). We reconstructed a computational foot model from a mild hallux valgus participant and conducted a gait analysis to drive the simulation of walking. Through parametric analysis, the stiffness of the ligaments was impoverished at different degrees to resemble different levels of generalized ligament laxity. Our simulation study reported that generalized ligament laxity deteriorated hallux valgus by impairing the loadbearing capacity of the first metatarsal, inducing higher deforming force, moment and malalignment at the first metatarsophalangeal joint. Besides, the deforming moment formed a deteriorating vicious cycle between hallux valgus and forefoot abduction and may result in secondary foot problems, such as flatfoot. However, the metatarsocuneiform joint did not show a worsening trend possibly due to the overriding forefoot abduction. Controlling the deforming load shall be prioritized over the correction of angles to mitigate deterioration or recurrence after surgery.

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Section: Discussionmentioning

confidence: 81%

Finite Element Analysis of Generalized Ligament Laxity on the Deterioration of Hallux Valgus Deformity (Bunion)

Wong

Yan

Chen

et al. 2020

Front. Bioeng. Biotechnol.

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“…Also the application of two construct for every case can may lead, in our opinion to a more reliable and stable fixation with a decreased future risk for hardware failure, because of load sharing. [51][52][53][54][55] Relative novelty and progressive evolution of the technique have not yet established a steady learning curve and a stable set of rules in order to have conclusive overall results on the medium and long-term. Our experience shows that, at present time a good level of confidence can be maintained in this technique and its advantages but also we accept and support the need for further testing and analysis of results of homogenous case series.…”

Section: Resultsmentioning

confidence: 99%

Results of Hallux Abducto Valgus Surgical Correction Using Two 1.1mm Mini TightRope Constructs

Nica¹,

Panaitescu²,

Creţu³

et al. 2020

Rev. Chim.

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Hallux valgus represents an acquired foot deformity defined by medial deviation of the first metatarsal bone combined with lateral shift of the hallux and medial metatarsophalageal joint eminence enlargement. The functional impairment and metatarsalgia generated stem from the biomechanical imbalance which does not allow for normal transfer of weight trough the first ray during walking. The results generated with our experience with the 1.1mm Mini TightRope® Disposable Kitin the treatment of hallux valgus are analyzed in this paper. A total number of 24 feet (12 bilateral cases) with hallux valgus, surgically treated in our department were followed for a period of minimum twelve months and evaluated. The results showed an improvement of the mean preoperative IMA 14.6°to 7.9° postoperatively and 9.2° at six months after surgery. The preoperative measured HVA was reduced from 28.4to 14.2° at once and 16.1° after six months. The AOFAS hallux metatarsophalangeal-interphalangeal score resulted improvement reflects the functional benefits. These results confirm the good correction potential of the technique and support it as avalid treatment option for mild to moderate severity hallux valgus.

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“…A modern wave of techniques has reintroduced this concept by applying a dynamic, flexible fixation of a corrected IMA using high-strength suture wires secured on bone with metallic buttons or anchors (metallic or biodegradable). Also, variations of these procedures can be used for tarsometatarsal stabilization in conjunction with osteotomies for bone correction [48][49][50]. The results seem promising but a longer followup and biomechanical testing are needed for a comprehensive recognition as a reliable treatment strategy.…”

Section: Minimally Invasive and Novel Proceduresmentioning

confidence: 99%

Review of current hallux valgus management options

Nica

Creţu

Ene

et al. 2019

Romanian Journal of Orthopaedic Surgery and Traumatology

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Hallux valgus is one of the most common forefoot pathologies, with a multifactorial etiology that causes important functional impairment and metatarsalgia. The characteristic deformity originates from a biomechanical imbalance induced by the disruption of first metatarsophalangeal joint alignment and manifests as an abnormal weight transfer on the first ray during walking. Conservative treatment is unable to correct the deformity or stop the evolution of the disease but can distinctly control the symptoms. With time, a myriad of surgical correction techniques have been developed but no definitive surgical treatment algorithm has been generally accepted. Nonetheless, the decision process for choosing the suitable technique must be completed on an individual basis after considering the deformity severity stratification, status of the metatarsophalangeal and tarsometatarsal joints, bone anatomy, and associated comorbidities. In spite of a large variety of surgical options, there are a few main strategies that incorporate these variations: metatarsophalangeal and/or tarsometatarsal joint fusion, metatarsal osteotomies and soft tissue procedures. Nowadays, the surgical management of hallux valgus is dominated by first metatarsal osteotomies performed through open surgery or minimally invasive techniques. Hallux valgus angle has been found to be the single most important parameter for surgical outcome prognostic.

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Short term results of osteotomy-sparing technique in management of moderate hallux valgus using TightRope system

Abstract: Osteotomy-sparing technique using TightRope device is effective in the management of moderate hallux valgus provided that proper patient selection, adequate surgical technique, and proper postoperative protocol are followed.

Cited by 4 publications

References 9 publications

Finite Element Analysis of Generalized Ligament Laxity on the Deterioration of Hallux Valgus Deformity (Bunion)

Finite Element Analysis of Generalized Ligament Laxity on the Deterioration of Hallux Valgus Deformity (Bunion)

Results of Hallux Abducto Valgus Surgical Correction Using Two 1.1mm Mini TightRope Constructs

Review of current hallux valgus management options

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