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Minimally invasive hallux

Carlo Biz, Michele Fosser, Miki Dalmau-Pastor, Marco Corradin, Maria Grazia Rodà, Roberto Aldegheri, Pietro Ruggieri
BACKGROUND: Minimally invasive surgery (MIS) represents one of the most innovative surgical treatments of hallux valgus (HV). However, long-term outcomes still remain a matter of discussion within the orthopaedic community. The purpose of this longitudinal prospective study was to evaluate radiographic and functional outcomes in patients with mild-to-severe HV who underwent Reverdin-Isham and Akin percutaneous osteotomy, following exostosectomy and lateral release. METHODS: Eighty patients with mild-to-severe symptomatic HV were treated by MIS...
December 5, 2016: Journal of Orthopaedic Surgery and Research
Kaiying Shen, Haiqing Cai, Zhigang Wang, Yunlan Xu
Elastic stable intramedullary nailing (ESIN) has became a well-accepted method of osteosynthesis of diaphyseal fractures in the skeletally immature patient for many advantages, the purpose of this study is to evaluate the preliminary results of this minimally invasive treatment for severely displaced distal tibial diaphyseal metaphyseal junction (DTDMJ) fractures.This study was carried out over a 6-year period. Twenty-one severely displaced DTDMJ fractures treated using ESIN were evaluated clinically and radiographically...
September 2016: Medicine (Baltimore)
Alireza Khosroabadi, Bradley M Lamm
Percutaneous surgical techniques and minimally invasive procedures in foot and ankle surgery are gaining interest for both patients and surgeons. Percutaneous surgery is defined by a soft tissue or osseous procedure performed through the smallest possible incision without direct visualization of the underlying target structures. Percutaneous surgery has many potential advantages, including quicker operative times, multiplanar osteotomy correction, smaller incisions, decreased scarring, lower complication rates, and faster recovery times...
November 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
A H Sott
First metatarsophalangeal joint arthrodesis plays a significant role in the management of symptomatic hallux rigidus/osteoarthritis of the 1st metatarsophalangeal joint. Several open and few percutaneous techniques have been described in the literature. This article describes and discusses a percutaneous technique that has been successfully used to achieve a pain-free stable and functional 1st metatarsophalangeal joint. All aspects of surgical indication and operative technique and details of patient-reported outcomes are presented with a referenced discussion...
September 2016: Foot and Ankle Clinics
Aisha Razik, A H Sott
Hallux rigidus is a degenerative condition leading to arthritis of the first metatarsophalangeal joint. Cheilectomy is a surgical procedure that is used in the treatment of hallux rigidus. It removes dorsal and dorsomedial or dorsolateral osteophytes, primarily relieving the impingement at the first metatarsophalangeal joint, which causes patients pain. The minimally invasive technique has proven to be an excellent technique to remove bony spurs to relieve symptoms with minimal surgical complications and fast recovery time...
September 2016: Foot and Ankle Clinics
Kit Brogan, Edward Lindisfarne, Harold Akehurst, Usama Farook, Will Shrier, Simon Palmer
BACKGROUND: Minimally invasive surgical (MIS) techniques are increasingly being used in foot and ankle surgery but it is important that they are adopted only once they have been shown to be equivalent or superior to open techniques. We believe that the main advantages of MIS are found in the early postoperative period, but in order to adopt it as a technique longer-term studies are required. The aim of this study was to compare the 2-year outcomes of a third-generation MIS distal chevron osteotomy with a comparable traditional open distal chevron osteotomy for mild-moderate hallux valgus...
November 2016: Foot & Ankle International
Tun Hing Lui
Flexor hallucis longus (FHL) tendon transfer is indicated for reconstruction of the Achilles tendon with a gap larger than 5 cm. The tendon can be harvested at zone 2 or zone 3 by minimally invasive techniques with the advantage of minimal soft-tissue dissection. The tendon can be harvested under the sustentaculum tali by zone 2 FHL tendoscopy. It is adequate for FHL transfer to the posterior calcaneal tubercle. If a double-thickness reconstruction of a huge gap of the Achilles tendon is indicated, the tendon can be harvested at the level of the hallux by means of a tendon stripper...
December 2015: Arthroscopy Techniques
Wei-dong Sun, Jian-min Wen
To treat hallux valgus, minimally invasive osteotomy on 1st metatarsal neck,immobilization with "8-shape" bandagev was performed, and the effect was definited. The principles of osteotomy stability were analyzed from the osteotomy position, methods, direction and angle. The grinding drill was used to increase friction coefficient between the ends of osteotomy. Correct direction of osteotomy and suitable angle were the key point of stability. The immobilization with "8-shape" bandage complied with the principle of elastic fixation created the conditions for the slight movement of the osteotomy ends...
March 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Hong-liang Li, Shu-yuan Li, Wei Qi, Chun-bao Li, Feng Qu, Guo Qi, Gang Zhao, Yu-jie Liu, Juan-li Zhu
OBJECTIVE: To evaluate the effect of arthroscopy-assisted minimally invasive management of bunion and hallux valgus deformities. METHODS: Total 50 patients (53 feet) with bunion and hallux valgus deformities were treated under arthroscopy from July 2008 to July 2011, with an average age of 42.3 years old (ranging from 30 to 65 years old) involving 19 left feet, 28 right feet and 3 both feet. The American Orthopedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal(MP-IP) Scale Score was used to evaluate the therapeutic effect...
February 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Juan Manuel Yañez Arauz, Jorge Javier Del Vecchio, Mariano Codesido, Nicolás Raimondi
BACKGROUND: Among the many surgical techniques used for hallux valgus correction, different osteotomies may be performed in the proximal phalanx as well as lateral release as associated procedures. The aim of this study is to analyze the anatomical relationships and the risks for the soft tissue lessions when performing the dorsomedial minimally invasive surgery (MIS) portal for the Akin osteotomy, and the MIS dorsolateral portal for lateral release, in order to define a safety zone when conducting the procedure in order to avoid complications...
June 2016: Foot
Blaž Mavčič
BACKGROUND: Minimally invasive distal metatarsal osteotomy (MIDMO) is to be indicated for all patients with angles of IMA <20° and HV <40°, but many authors doubt whether this procedure is capable of correcting all types of hallux valgus deformities. The aims of this study were to perform a geometric analysis of MIDMO indications and to show which preoperative radiological parameters are necessary to achieve sufficient contact between bone fragments and sufficient correction with this operative technique...
October 17, 2015: Journal of Orthopaedic Surgery and Research
Richard Walter, Anthony Perera
Cheilectomy consists of excision of the dorsal exostosis and part of the metatarsal head. It is typically performed for patients in the earlier stages of hallux rigidus presenting with dorsal pain and dorsiflexion stiffness in the absence of through-range symptoms, rest pain, and plantar pain and with negative result on grind test. If joint motion-preserving surgery is appropriate, then cheilectomy is generally considered to be the first-line surgical choice. In addition to the standard open technique, minimally invasive surgery in the form of either percutaneous or arthroscopic surgery is available...
September 2015: Foot and Ankle Clinics
Peter Bock, Rainer Kluger, Karl-Heinz Kristen, Martina Mittlböck, Reinhard Schuh, Hans-Joerg Trnka
BACKGROUND: Little is known about the long-term results of surgical correction of hallux valgus deformity, in particular, the recurrence rate and factors leading to recurrence. METHODS: Of one hundred and eight patients (115 feet) who underwent a Scarf osteotomy, ninety-three patients (ninety-three feet) were examined at an average duration of follow-up of 124 months. Clinical examination before surgery and at the time of final follow-up included an evaluation of range of motion, pain as measured with a visual analog scale, and American Orthopaedic Foot & Ankle Society (AOFAS) scores...
August 5, 2015: Journal of Bone and Joint Surgery. American Volume
David Redfern, Joel Vernois, Barbara Piclet Legré
This article describes some of the common techniques used in percutaneous surgery of the forefoot. Techniques such as minimally invasive chevron Akin osteotomy for correction of hallux valgus, first metatarsophalangeal joint cheilectomy, distal minimally invasive metatarsal osteotomies, bunionette correction, and hammertoe correction are described. This article is an introduction to this rapidly developing area of foot and ankle surgery. Less invasive techniques are continually being developed across the whole spectrum of surgical specialties...
July 2015: Clinics in Podiatric Medicine and Surgery
T H Lui
Enchondromas are the most commonly found benign tumors of the small bones of the foot, mainly involve the phalanges and metatarsals. They are usually asymptomatic, and are found as an incidental finding on routine X-rays. Surgical intervention is indicated in symptomatic lesions as well as larger lesions (greater than 3-4cm) even if these lesions are asymptomatic. Enchondroma most often can be adequately treated with intralesional curettage and bone grafting. A technique of endoscopic curettage and bone grafting of enchondroma of the proximal phalanx of the hallux is described...
June 2015: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Alberto Siclari, Marco Piras
With mounting attention focused on decreasing postsurgical pain and dysfunction, emphasis has been placed on approaching disorders using minimally invasive techniques. Surgical procedures of the hallux, such as hallux valgus correction, have earned the reputation for high postsurgical pain and prolonged recovery. Arthroscopic hallux procedures have the advantages of minimizing pain, swelling, and disability. Certain conditions, such as synovitis, loose bodies, and early-grade hallux rigidus, are better addressed arthroscopically...
March 2015: Foot and Ankle Clinics
Kenneth J Hunt
UNLABELLED: Arthroscopy of the hallux metatarsophalangeal (MTP) joint is an evolving technique for hallux rigidus and other disorders of the hallux MTP joint. Purported advantages of this minimally invasive procedure include rapid rehabilitation and the ability to identify and address other intra-articular and sesamoid pathologies without additional dissection. Larger, prospective, and comparative outcomes studies are needed to optimize the treatment algorithm. LEVEL OF EVIDENCE: Level V, expert opinion...
January 2015: Foot & Ankle International
Artur Gądek, Henryk Liszka, Jerzy Wordliczek
BACKGROUND: Several techniques of anesthesia are used in foot surgery. Preemptive analgesia helps to prevent the development of hypersensitivity in the perioperative period. The aim of our study was to assess the role of preemptive local anesthetic infiltration and postoperative pain after hallux valgus surgery. METHODS: We evaluated 118 patients who underwent modified chevron and mini-invasive Mitchell-Kramer bunionectomy of the first distal metatarsal. After spinal anesthesia each patient randomly received an infiltration of local anesthetic or the same amount of normal saline 10 minutes before the skin incision...
March 2015: Foot & Ankle International
R Díaz Fernández
OBJECTIVE: To evaluate the clinical and radiological results in the surgical treatment of moderate and severe hallux valgus by performing percutaneous double osteotomy. MATERIAL AND METHOD: A retrospective study was conducted on 45 feet of 42 patients diagnosed with moderate-severe hallux valgus, operated on in a single centre and by the same surgeon from May 2009 to March 2013. Two patients were lost to follow-up. Clinical and radiological results were recorded...
January 2015: Revista Española de Cirugía Ortopédica y Traumatología
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