Biomechanical Comparison of 2 Common Techniques of Minimally Invasive Hallux Valgus Correction

2020 ◽  
pp. 107110072095902
Author(s):  
Amiethab Aiyer ◽  
Dustin H. Massel ◽  
Noman Siddiqui ◽  
Jorge I. Acevedo
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Ultimate Load ◽  
Biomechanical Testing ◽  
Osteotomy Site ◽  
Yield Load ◽  
Chevron Osteotomy ◽  
Significant Difference ◽  
Load To Failure ◽  
Biomechanical Strength

Background: Hallux valgus is one of the most common surgically corrected forefoot deformities. Compared to open procedures, minimally invasive (MIS) treatment of hallux valgus has resulted in decreased operative time, reduced complication rates, and greater patient satisfaction. Historically, distal chevron osteotomies are the standard for moderate hallux valgus correction. To our knowledge, no studies have evaluated biomechanical strength of transverse and chevron distal first metatarsal osteotomy (DMO) constructs. The purpose of this study was to evaluate the biomechanical strength of these techniques. Methods: Eighteen cadaveric specimens (9 matched pairs) were randomized to transverse or chevron DMO. Each technique was performed by a separate fellowship-trained orthopedic foot and ankle surgeon. Radiographic images were analyzed. Biomechanical testing was performed using Instron Mechanical System. Ultimate load to failure, yield load, and stiffness were assessed. A 10-N preload was applied to the sesamoid bones for stability. A coaxial compression rate (10 mm/min) was applied until failure was observed. Mean and standard deviations were compared. All cadaveric specimens were male. Results: There was no significant difference in percent metadiaphyseal shift between osteotomies ( P = .453). The most common mode of failure was fracture at screw insertion site (55.6%), followed by failure at osteotomy site (44.4%). A trend toward increased ultimate load to failure ( P = .480), yield load ( P = .054), and stiffness ( P = .438) among transverse compared to chevron osteotomy was observed, but this difference was not statistically significant. Conclusion: Biomechanical testing demonstrated no significant difference in ultimate load, yield load, and stiffness between MIS transverse and chevron osteotomy constructs; a trend toward increased strength in the transverse osteotomy cohort was observed. Chevron osteotomies may result in early failure by relative ease of cutout through cancellous bone compared to transverse osteotomies in which failure requires cortical cutout. Clinical Relevance: Use of MIS techniques for hallux valgus correction is gaining clinical traction. Although various clinical studies have evaluated outcomes of these MIS techniques, biomechanical studies have been minimal. Specifically, the potential biomechanical benefits of various MIS hallux valgus osteotomy techniques have not been delineated to date. The content of this manuscript is quite timely, given the rise in use of these MIS techniques.

scholarly journals Hallux Valgus Correction: Comparison of Minimally Invasive Transverse and Chevron Distal Metatarsal Osteotomy Constructs

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0006
Author(s):  
Dustin H. Massel ◽  
Amiethab A. Aiyer ◽  
Jorge I. Acevedo
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Ultimate Load ◽  
Biomechanical Testing ◽  
Metatarsal Osteotomy ◽  
Sesamoid Bones ◽  
Load To Failure ◽  
Distal Metatarsal Osteotomy ◽  
Transverse Osteotomy ◽  
Biomechanical Strength

Category: Basic Sciences/Biologics; Bunion Introduction/Purpose: Hallux valgus is one of the most common surgically corrected forefoot deformities. Compared to open procedures, minimally invasive treatment of hallux valgus has resulted in decreased operative time, reduced complication rates, and greater patient satisfaction. Until recently in the United States, distal chevron osteotomies have been the standard for hallux valgus correction of moderate deformity. To the best of the authors’ knowledge, no studies have evaluated biomechanical strength of transverse and chevron distal metatarsal osteotomy constructs. The purpose of this study was to evaluate the biomechanical strength of transverse and chevron minimally invasive osteotomy techniques using 9 matched cadaveric pairs. Methods: A total of nine matched cadaveric specimens were randomized to transverse or chevron distal metatarsal osteotomies. Each minimally invasive surgical technique was performed by a fellowship trained orthopedic foot and ankle surgeon. Anterior- posterior and lateral radiographic images were obtained following surgical fixation. Biomechanical testing was performed on an Instron Mechanical System. Ultimate load to failure, yield load, and stiffness were assessed across the fixation construct with fulcrum within the metatarsal shaft proximal to screw fixation and compression load at the sesamoid bones. A pre-load of 10N was applied to the sesamoid bones by the compression post to stabilize the sample. Subsequently, a compression rate was applied to the sample at 10mm/min until failure was observed. Mean and standard deviations were assessed and compared across cohorts. Results: All nine cadaveric specimens were male. There was no difference in average percent metadiaphyseal shift among transverse (36%) and chevron (38%) osteotomies. The most common mode of failure among transverse and chevron osteotomies was fracture at screw insertion site (55.6%), followed by failure at osteotomy site (44.4%). One paired sample was noted to have poor bone quality prior to biomechanical testing. There was a trend towards increased ultimate load to failure (p=0.480) and stiffness (p=0.438) among transverse osteotomy compared to chevron osteotomy, however, no statistically significant difference was observed. Conclusion: Biomechanical testing demonstrates no statistical difference in ultimate load to failure and stiffness between minimally invasive transverse and chevron distal metatarsal osteotomy constructs. A trend towards increased ultimate load and stiffness in the transverse osteotomy cohort was observed. Chevron osteotomies violate the entire plantar cortex and may result in early failure by relative ease of cutout through cancellous bone compared to transverse osteotomies in which failure would require cortical bone cutout. Future studies are required to evaluate strength of construct in a larger sample. Analysis is limited, healing may provide additional strength that is not simulated in cadaveric studies.

scholarly journals Biomechanical Comparison of a Prepared Thick Fresh Frozen Irradiated Fascia Lata Allograft to the Native Superior Capsule (212)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0032
Author(s):  
Nicholas Debellis ◽  
John Manning ◽  
James Tibone ◽  
Michelle McGarry ◽  
Gregory Adamson ◽  
...  
Keyword(s):  
Ultimate Load ◽  
Fascia Lata ◽  
Cadaveric Specimen ◽  
Yield Load ◽  
Total Displacement ◽  
Pull Out ◽  
Significant Difference ◽  
Load To Failure ◽  
Fresh Frozen ◽  
Biomechanical Comparison

Objectives: Superior Capsule Reconstruction (SCR) has been described as treatment option for irreparable tears of the superior rotator cuff. Reported outcomes on the success of the surgery have been variable, with graft choice seeming to be one of the most important factors. Fascia Lata (FL) allograft has been proposed as a potential option as it provides adequate graft thickness while avoiding the morbidity of an autograft harvest. The purpose of this study was to compare the biomechanical characteristics of an SCR with FL allograft (FL-SCR) to a native superior capsule in a cadaveric specimen. Methods: Eight cadaver shoulder specimens were used. Each specimen was tested with a custom shoulder system twice. Initial testing was performed after the specimen was dissected of all soft tissue except for the native superior capsule. Subsequent testing was performed after FL-SCR was done. All allografts were fresh frozen and irradiated. Capsule and graft dimensions were recorded before testing. Biomechanical values recorded were cyclic and load to failure for both the native capsule and FL-SCR, and fixation displacement for the SCR-FL construct. A Paired T-test was performed to compare the biomechanical values of the native superior capsule to the FL-SCR. Results: The mean thickness of the NSC was 2.4 ± 0.6 mm and 7.4 ± 1.2mm for the FL graft. The native superior capsule had an average linear stiffness of 94.5 ± 20.4 N/mm, yield load of 386.9 ± 63.6 N, ultimate load of 444.9 ± 67.7 N and energy absorbed of 1418.4 ± 248.8 N-mm. The FL-SCR construct had an average linear stiffness of 28.0 ± 1.6 N/mm, yield load of 123.8 ± 54.3 N, ultimate load of 369.0 ± 43.4 N and energy absorbed of 5021.2 ± 755.1 N-mm. Comparing the two groups there was a statistically significant difference for stiffness (P = 0.013), yield load (P = 0.03) and energy absorbed (P = 0.003). There was no statistically significant difference between ultimate load. The total displacement of the FL-SCR fixation was 5.8 ± 0.6 mm after 1 cycle, 8.5 ± 0.7 mm after 30 cycles, 11.4 ± 1.8 mm at the yield load and 29.5 ± 1.8 mm at the ultimate load. For the failure mode, 8/8 NSC specimens failed at the mid-substance. The FL-SCR, 3/8 specimens failed at the suture tendon interface and 4/8 had medial anchor pull out. Conclusions: Performing SCR with FL allograft in a cadaver model creates a construct that is sufficiently strong enough to withstand normal physiologic loading of the shoulder, although it does not fully re-create the biomechanical characteristics of a native shoulder superior capsule.

scholarly journals Biomechanical stability of complex coronal plane fracture fixation of the capitellum

2021 ◽  
Author(s):  
Paul Borbas ◽  
Rafael Loucas ◽  
Marios Loucas ◽  
Maximilian Vetter ◽  
Simon Hofstede ◽  
...  
Keyword(s):  
Fracture Fixation ◽  
Ultimate Load ◽  
Locking Plate ◽  
Distal Humerus ◽  
Coronal Plane ◽  
Fixation Strength ◽  
Biomechanical Stability ◽  
Significant Difference ◽  
Load To Failure ◽  
Headless Compression Screws

Abstract Introduction Coronal plane fractures of the distal humerus are relatively rare and can be challenging to treat due to their complexity and intra-articular nature. There is no gold standard for surgical management of these complex fractures. The purpose of this study was to compare the biomechanical stability and strength of two different internal fixation techniques for complex coronal plane fractures of the capitellum with posterior comminution. Materials and methods Fourteen fresh frozen, age- and gender-matched cadaveric elbows were 3D-navigated osteotomized simulating a Dubberley type IIB fracture. Specimens were randomized into one of two treatment groups and stabilized with an anterior antiglide plate with additional anteroposterior cannulated headless compression screws (group antiGP + HCS) or a posterolateral distal humerus locking plate with lateral extension (group PLP). Cyclic testing was performed with 75 N over 2000 cycles and ultimately until construct failure. Data were analyzed for displacement, construct stiffness, and ultimate load to failure. Results There was no significant difference in displacement during 2000 cycles (p = 0.291), stiffness (310 vs. 347 N/mm; p = 0.612) or ultimate load to failure (649 ± 351 vs. 887 ± 187 N; p = 0.140) between the two groups. Conclusions Posterolateral distal humerus locking plate achieves equal biomechanical fixation strength as an anterior antiglide plate with additional anteroposterior cannulated headless compression screws for fracture fixation of complex coronal plane fractures of the capitellum. These results support the use of a posterolateral distal humerus locking plate considering the clinical advantages of less invasive surgery and extraarticular metalware. Level of evidence Biomechanical study.

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

2018 ◽  
Vol 39 (11) ◽  
pp. 1355-1359 ◽  
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.

Third-Generation Minimally Invasive Chevron-Akin Osteotomy for Hallux Valgus Produces Similar Clinical and Radiological Outcomes as Scarf-Akin Osteotomy at 2 Years: A Matched Cohort Study

2021 ◽  
pp. 107110072110491
Author(s):  
Adriel You Wei Tay ◽  
Graham S. Goh ◽  
Kevin Koo ◽  
Nicholas Eng Meng Yeo
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Physical Component Score ◽  
Control Group ◽  
Component Score ◽  
Vas Score ◽  
Sf 36 ◽  
Significant Difference ◽  
Akin Osteotomy ◽  
New Generation

Background: The minimally invasive chevron-Akin (MICA) osteotomy is an increasingly popular technique for the correction of hallux valgus. However, there is a paucity of literature comparing it with traditional open techniques. The purpose of this study was to compare the clinical and radiological outcomes of the MICA osteotomy using a new-generation MICA screw and scarf-Akin osteotomy for hallux valgus correction. Methods: Thirty cases of MICA osteotomy were propensity score matched 1:1 with a control group of 30 scarf-Akin osteotomy cases. The groups were matched for age, sex, body mass index, preoperative visual analog scale (VAS) score, American Orthopaedic Foot & Ankle Society (AOFAS) metatarsophalangeal-interphalangeal (MTP-IP) score, 36-Item Short-Form Health Survey (SF-36) physical component score (PCS) and mental component score (MCS), preoperative hallux valgus angle (HVA) and intermetatarsal angle (IMA), and concomitant procedures. Outcomes were compared at 6 and 24 months postoperatively. Early postoperative VAS scores were also compared. Results: Both groups demonstrated significant improvements in VAS score, AOFAS score, and SF-36 PCS and MCS at 6 and 24 months postoperatively. For the MICA group, HVA improved from 23.5 to 7.7 degrees, and IMA improved from 13.5 to 7.5 degrees. For the scarf-Akin osteotomy group, HVA improved from 23.7 to 9.3 degrees, and IMA improved from 13.6 to 7.8 degrees. The first 24-hour postoperative VAS score was significantly lower in the MICA group compared with the scarf-Akin group (2.0 ± 2.0 vs 3.4 ± 2.6, P = .029). However, there was no significant difference in clinical or radiological outcomes between the groups at 6 and 24 months. Conclusion: The MICA procedure with the new-generation MICA screw is an attractive option for the correction of hallux valgus, yielding similar midterm radiological and clinical outcomes compared with the well-established scarf-Akin osteotomy. The first 24-hour postoperative VAS score in the MICA group was also statistically lower, although its clinical significance remains to be determined. Level of Evidence: Level III, retrospective comparative study.

scholarly journals Radiological Outcomes of Third Generation Minimally Invasive Chevron Akin Osteotomies (MICA) for Hallux Valgus

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0032
Author(s):  
Thomas L. Lewis ◽  
Robbie Ray; David Gordon
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Weight Bearing ◽  
Case Series ◽  
Deformity Correction ◽  
Third Generation ◽  
Radiographic Measurements ◽  
Significant Difference ◽  
Patient Reported ◽  
The Mean

Category: Bunion Introduction/Purpose: Minimally invasive surgery for hallux valgus has significantly increased in popularity recently due to smaller incisions, reduced soft tissue trauma, and the ability to achieve large deformity corrections compared to traditional treatments. This study aimed to investigate the radiological outcomes and degree of deformity correction of the intermetatarsal angle (IMA) and the hallux valgus angle (HVA) following third generation (using screw fixation) Minimally Invasive Chevron and Akin Osteotomies (MICA) for hallux valgus. Methods: A single surgeon case series of patients with hallux valgus underwent primary, third generation MICA for hallux valgus. Pre- and post-operative (6 weeks after surgery) radiological assessments of the IMA and HVA were based on weight-bearing dorso-plantar radiographs. Radiographic measurements were conducted by two foot & ankle fellowship trained consultant surgeons (RR, DG). Paired t-tests were used to determine the statistically significant difference between pre- and post-operative measurements. Results: Between January 2017 and December 2019, 401 MICAs were performed in 274 patients. Pre- and post-operative radiograph measurements were collected for 348 feet in 232 patients (219 female; 13 male). The mean age was 54.4 years (range 16.3-84.9, standard deviation (s.d.) 13.2). Mean pre-operative IMA was 15.3° (range 6.5°-27.0°, s.d. 3.4°) and HVA was 33.8° (range 9.3°-63.9°, s.d. 9.7°). Post-operatively, there was a statistically significant improvement in radiological deformity correction; mean IMA was 5.3° (range -1.2°-16.5°, s.d. 2.7°, p<0.001) and mean HVA was 8.8° (range -5.2°-24.0°, s.d. 4.5°, p<0.001). The mean post-operative reduction in IMA and HVA was 10.0° and 25.0° respectively. Conclusion: This is the largest case series demonstrating radiological outcomes following third generation Minimally Invasive Chevron and Akin Osteotomies (MICA) for hallux valgus to date. These data show that this is an effective approach at correcting both mild and severe hallux valgus deformities. Longer term radiological outcome studies are needed to investigate whether there is any change in radiological outcomes. Correlation with patient reported outcomes is planned.

scholarly journals Comparison of Bioabsorbable Magnesium versus Titanium Screw Fixation for Modified Distal Chevron Osteotomy in Hallux Valgus

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Baver Acar ◽  
Ozkan Kose ◽  
Adil Turan ◽  
Melih Unal ◽  
Yusuf Alper Kati ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Screw Fixation ◽  
Clinical Results ◽  
Significant Loss ◽  
Compression Screw ◽  
Titanium Screw ◽  
Chevron Osteotomy ◽  
Valgus Angle ◽  
Significant Difference ◽  
Screw Group

Objective. The purpose of this retrospective study was to compare the clinical and radiological results of magnesium versus titanium screw fixation for modified distal chevron osteotomy in hallux valgus (HV). Materials and Methods. A total of 31 patients who underwent modified distal chevron osteotomy for HV deformity between 2014 and 2017 were reviewed retrospectively. Headless magnesium (Mg) compression screw fixation was applied in 16 patients (17 feet) and headless titanium (Ti) compression screw in 15 patients (17 feet). Patients were followed up for at least 12 months with a mean of 19.0 ± 6.8 months in the Mg screw group and 16.2 ± 6.19 in the Ti screw group, respectively (p: 0.234). Clinical results were evaluated using the American Orthopedic Foot and Ankle Society Hallux metatarsophalangeal-interphalangeal (AOFAS-MTP-IP) scale and a visual analogue scale (VAS). The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured before and after surgery. Time to osteotomy union and any complications were recorded and compared between the groups. Results. An improvement in the AOFAS-MTP-IP scale and VAS points were recorded in both groups with no statistically significant difference between the groups (p: 0.764 and 0.535, resp.). At the final follow-up examination, HVA and IMA were similar (p: 0.226 and 0.712, resp.). There was no significant loss of correction between the early and final radiographs in respect of HVA and IMA in both groups (p: 0.321 and p: 0.067). Full union of the osteotomy was obtained in all patients. Prolonged (1.5 months) swelling and mild hyperemia around the surgical incision were observed in 1 patient in the Mg group but there was a good response to physical and medical therapy, and the complaints were completely resolved. There were no other significant complications in either group. Conclusion. The results of this study showed that bioabsorbable Mg compression screw fixation has similar therapeutic efficacy to Ti screw fixation in respect of functional and radiological outcomes. Bioabsorbable Mg screw is an alternative fixation material that can be safely used for modified distal chevron osteotomy in HV surgery.

Biomechanical Evaluation of Minimally Invasive Repairs for Complete Acromioclavicular Joint Dislocation

2007 ◽  
Vol 35 (6) ◽  
pp. 955-961 ◽  
Author(s):  
Mathias Wellmann ◽  
Thore Zantop ◽  
Andre Weimann ◽  
Michael J. Raschke ◽  
Wolf Petersen
Keyword(s):  
Minimally Invasive ◽  
Ultimate Load ◽  
Suture Anchor ◽  
Biomechanical Properties ◽  
Fixation Strength ◽  
Acromioclavicular Joint Dislocation ◽  
Coracoclavicular Ligament ◽  
Invasive Approach ◽  
Significant Difference ◽  
Permanent Elongation

Background The conventional coracoclavicular ligament augmentation with a single polydioxanone loop has been shown to have some pivotal disadvantages. Hypothesis A minimally invasive flip button/polydioxanone repair provides similar biomechanical properties to the conventional polydioxanone cerclage around the coracoid. However, the authors expected a difference in linear stiffness, ultimate load, and permanent elongation between suture anchor repairs and polydioxanone repairs. Study Design Controlled laboratory study. Methods The tensile fixation strength of 4 different minimally invasive repairs was tested in a porcine metatarsal model: (1) 1.3-mm single polydioxanone cerclage with a subcoracoidal flip button fixation, (2) 1.3-mm single polydioxanone cerclage, (3) Twinfix Ti 3.5-mm/Ultrabraid 2-suture anchor, and (4) Twinfix Ti 5.0-mm/Ultrabraid 2-suture anchor. The testing protocol included cyclic superoinferior loading and a subsequent load to failure trial. Results The flip button repair (646 N) and the conventional polydioxanone banding (663 N) revealed significant higher ultimate loads than did the suture anchor repairs (295 and 331 N, respectively; P < .001), whereas no significant differences were found for the elongation behavior under cyclic loading. Conclusion There was no significant difference between the 2 polydioxanone repairs. The ultimate load of the flip button procedure reaches the level of the native coracoclavicular ligament complex as it has been quantified in the literature. Clinical Relevance Although the biomechanical results comparing a minimally invasive flip button procedure versus a conventional polydioxanone cerclage are similar, the authors recommend the flip button procedure because of its minimally invasive approach and the secure subcoracoidal fixation technique with a minimized risk of anterior loop dislocation and neurovascular damage.

scholarly journals Biomechanical Strength of Scaphoid Partial Unions

2018 ◽  
Vol 07 (05) ◽  
pp. 399-403 ◽  
Author(s):  
Mark Snoddy ◽  
Donald Lee ◽  
Marc Richard ◽  
Mihir Desai ◽  
Adam Brekke
Keyword(s):  
Failure Mechanism ◽  
Clinical Relevance ◽  
Permanent Deformation ◽  
Maximum Load ◽  
Control Group ◽  
Average Maximum ◽  
Significant Difference ◽  
Load To Failure ◽  
Biomechanical Strength ◽  
Inherent Stability

Background It remains unknown how much force a partially united scaphoid can sustain without refracturing. This is critical in determining when to discontinue immobilization in active individuals. Purpose The purpose of this study was to test the biomechanical strength of simulated partially united scaphoids. We hypothesized that no difference would exist in load-to-failure or failure mechanism in scaphoids with 50% or more bone at the waist versus intact scaphoids. Materials and Methods Forty-one cadaver scaphoids were divided into four groups, three experimental osteotomy groups (25, 50, and 75% of the scaphoid waist) and one control group. Each was subjected to a physiologic cantilever force of 80 to 120 N for 4,000 cycles, followed by load to failure. Permanent deformation during physiologic testing and stiffness, max force, work-to-failure, and failure mechanism during load to failure were recorded. Results All scaphoids survived subfailure conditioning with no significant difference in permanent deformation. Intact scaphoids endured an average maximum load to failure of 334 versus 321, 297, and 342 N for 25, 50, and 75% groups, respectively, with no significant variance. There were no significant differences in stiffness or work to failure between intact, 25, 50, and 75% groups. One specimen from each osteotomy group failed by fracturing through the osteotomy; all others failed near the distal pole loading site. Conclusion All groups behaved similarly under physiologic and load-to-failure testing, suggesting that inherent stability is maintained with at least 25% of the scaphoid waist intact. Clinical Relevance The data provide valuable information regarding partial scaphoid union and supports mobilization once 25% union is achieved.

scholarly journals Distal Chevron Osteotomy vs The Simple, Effective, Rapid, Inexpensive Technique (SERI) for Mild to Moderate Isolated Hallux Valgus: A Randomized Controlled Study

2020 ◽  
Author(s):  
Ezequiel Palmanovich ◽  
Nissiom Ohana* - equal first author contribution ◽  
Ilan Small ◽  
Iftach Hetsroni ◽  
Eyal Amar ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Controlled Study ◽  
Wound Complications ◽  
Invasive Technique ◽  
Control Group ◽  
Chevron Osteotomy ◽  
The Mean ◽  
One Year

Abstract Background Hallux valgus is a common foot deformity that leads to functional disability with serious sequelae. Minimally invasive surgery is often used to treat hallux valgus in order to reduce wound complications and improve recovery time. The objective of this study was to compare a Simple, Effective, Rapid, Inexpensive (SERI) technique with a simple Chevron technique in patients with minimum of one-year follow. Methods and Materials Between the years 2014-2015 we performed a prospective study comparing the SERI minimally invasive technique to treat symptomatic hallux valgus with a standard chevron osteotomy technique. All procedures were performed by a single fellowship trained foot and ankle surgeon. Twenty-one patients were randomized to the SERI cohort and 15 to the standard Chevron technique. Results The mean pre-operative intermetatarsal angle (IMA) of the SERI group was 14.8 ± 1.9 (11.9 - 22.9). The mean pre-operative IMA of the Chevron control group was 13.3 ± 2.3 (10.4 -18.2) (p = 0.038). The mean IMA two weeks after surgery was 6.0 ± 2.3 (2.4-12) in the SERI group, and 6.1 ± 3 (2.6-13.1) in the control group. At the two week and one year follow up, there was no significant difference found in the IMA between the two groups (p = 0.871). Neither groups reported symptomatic transfer metatarsalgia throughout the follow up period. The SERI group had increased metatarsophalangeal joint (MTPJ) motion (p < 0.001) however, all other parameters with similar. Conclusion The SERI technique provided comparable outcomes at up to one year follow up when compared to a standard Chevron osteotomy for moderate hallux valgus. This study demonstrated good reproducible results using the SERI technique for moderate hallux valgus.

Sign in / Sign up

Export Citation Format

Share Document