Hallux Valgus Surgery: The Minimally Invasive Bunion Correction (SERI)

Background: Minimally invasive surgery for the treatment of hallux valgus deformities has become increasingly popular. Knowledge of the location of the hallux metatarsophalangeal (MTP) proximal capsular origin on the metatarsal neck is essential for surgeons in planning and executing extracapsular corrective osteotomies. A cadaveric study was undertaken to further study this anatomic relationship. Methods: Ten nonpaired fresh-frozen frozen cadaveric specimens were used for this study. Careful dissection was performed, and the capsular origin of the hallux MTP joint was measured from the central portion of the metatarsal head in the medial, lateral, dorsal, plantarmedial, and plantarlateral dimensions. Results: The ten specimens had a mean age of 77 years, with 5 female and 5 male. The mean distances from the central hallux metatarsal head to the MTP capsular origin were 15.2 mm dorsally, 8.4 mm medially, 9.6 mm laterally, 19.3 mm plantarmedially, and 21.0 mm plantarlaterally. Conclusion: The MTP capsular origin at the hallux metatarsal varies at different anatomic positions. Knowledge of this capsular anatomy is critical for orthopedic surgeons when planning and performing minimally invasive distal metatarsal osteotomies for the correction of hallux valgus. Type of Study: Cadaveric Study.

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Letter Regarding: Biomechanical Comparison of 2 Common Techniques of Minimally Invasive Hallux Valgus Correction

Foot & Ankle International ◽

10.1177/1071100721992753 ◽

2021 ◽

Vol 42 (3) ◽

pp. 381-382

Author(s):

Thomas L. Lewis ◽

Robbie Ray ◽

Peter Robinson ◽

Paul M. C. Dearden ◽

Thomas J. Goff ◽

...

Keyword(s):

Minimally Invasive ◽

Hallux Valgus ◽

Biomechanical Comparison

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Minimally Important Difference in the Foot and Ankle Outcome Score Among Patients Undergoing Hallux Valgus Surgery

Foot & Ankle International ◽

10.1177/1071100719831392 ◽

2019 ◽

Vol 40 (6) ◽

pp. 694-701 ◽

Cited By ~ 3

Author(s):

Sameer Desai ◽

Alexander C. Peterson ◽

Kevin Wing ◽

Alastair Younger ◽

Trafford Crump ◽

...

Keyword(s):

Activities Of Daily Living ◽

Hallux Valgus ◽

Daily Living ◽

Patient Reported Outcomes ◽

Minimally Important Difference ◽

Foot And Ankle ◽

Outcome Score ◽

Patient Reported ◽

Bunion Correction ◽

Correction Surgery

Background: Patient-reported outcomes are increasingly used as measures of effectiveness of interventions. To make the tools more useful, therapeutic thresholds known as minimally important differences have been developed. The objective of this study was to calculate minimally important differences for the domains of the Foot and Ankle Outcome Score for hallux valgus surgery. Methods: The study was based on a retrospective analysis of patients newly scheduled for bunion correction surgery and completing patient-reported outcomes between October 2013 and January 2018. This study used anchor- and distribution-based approaches to calculate the minimally important difference for the instrument’s 5 domains. Confidence intervals were calculated for each approach. There were 91 participants included in the study. Results: Using anchor- and distribution-based approaches, the minimally important difference for the pain domain ranged from 5.8 to 10.2, from 0.3 to 6.9 for the symptoms domain, 8.3 to 10.3 for the activities of daily living domain, 7.4 to 11.1 for the quality of life domain, and from 7.0 to 15.7 for the sports and recreation domain. Small differences in the activities of daily living domain may be more clinically important for patients with better function. Discussion: The range of minimally important difference values for each domain indicate how the Foot and Ankle Outcome Score corresponded to bunion correction surgery. The sports and recreation domain showed considerable variability in the range of values and may be associated with the domain’s lack of responsiveness. Overall, most minimally important difference values for the domains of FAOS ranged from above 4 to below 16. Level of Evidence: Level III, retrospective comparative series.

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Minimally invasive Hallux valgus Correction with Internal Hallux Fixator® - A comparative Cadaver Study

Foot and Ankle Surgery ◽

10.1016/j.fas.2021.05.002 ◽

2021 ◽

Author(s):

Natalia Gutteck ◽

Melina Ulbricht ◽

Karl-Stefan Delank ◽

Heike Kielstein ◽

Sebastian Schilde

Keyword(s):

Minimally Invasive ◽

Hallux Valgus ◽

Cadaver Study

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Short-term, Retrospective Radiographic Evaluation Comparing Pre- and Postoperative Measurements in the Chevron and Minimally Invasive Distal Metatarsal Osteotomy for Hallux Valgus Correction

The Journal of Foot & Ankle Surgery ◽

10.1053/j.jfas.2021.04.019 ◽

2021 ◽

Author(s):

Noman A. Siddiqui ◽

Brittany E. Mayer ◽

Jessica N. Fink

Keyword(s):

Minimally Invasive ◽

Hallux Valgus ◽

Radiographic Evaluation ◽

Metatarsal Osteotomy ◽

Short Term ◽

Distal Metatarsal Osteotomy

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Risk of Damaging Anatomical Structures During Minimally Invasive Hallux Valgus Correction (Bösch Technique): An Anatomical Study

Foot & Ankle International ◽

10.1177/1071100718786883 ◽

2018 ◽

Vol 39 (11) ◽

pp. 1355-1359 ◽

Cited By ~ 7

Author(s):

Martin Kaipel ◽

Lukas Reissig ◽

Lukas Albrecht ◽

Stefan Quadlbauer ◽

Joachim Klikovics ◽

...

Keyword(s):

Minimally Invasive ◽

Hallux Valgus ◽

Complication Rate ◽

Metatarsal Osteotomy ◽

Anatomical Structures ◽

Intensive Training ◽

Increased Risk ◽

Significant Difference ◽

Group A ◽

Group B

Background: Percutaneous, transverse distal metatarsal osteotomy with K-wire fixation (the Bösch technique) is an established technique for hallux valgus correction. Nevertheless, the risk of damaging the anatomical structures during the operation is unknown. Methods: Forty fresh-frozen anatomical foot specimens with hallux valgus deformity underwent a percutaneous corrective procedure. Specimens of group A (n = 20) were operated by an experienced surgeon while specimens of group B (n = 20) were done by untrained residents. Results: The dorsal cutaneous nerve was injured in 1 of 20 cases in group A and 6 of 20 cases in group B ( P = .037). There was a significant difference in overall complication rate between specimens of group A and group B ( P = .043). Conclusions: The results show an increased risk of perioperative injury of the dorsal cutaneous branch of the deep peroneal nerve as well as a significant effect of the surgeon’s experience on the overall complication rate. Clinical Relevance: Results of this study are highly relevant for all surgeons who perform percutaneous, minimally invasive hallux valgus surgery to avoid damage to the peripheral nerves. In addition, the data suggest an intensive training for surgeons before minimally invasive hallux valgus surgery is performed without supervision.

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