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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 10/2023

18-05-2023 | Hallux Valgus | Orthopaedic Surgery

A modified minimally invasive osteotomy for hallux valgus enables reduction of malpositioned sesamoid bones

Authors: Ezequiel Palmanovich, Nissim Ohana, Alex Tavdi, Ran Atzmon, Viktor Feldman, Yaron S. Brin, Meir Nyska, David Segal

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2023

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Abstract

Background

The current minimally invasive distal metatarsal osteotomy for hallux valgus (HV) is V-shaped, which prevents the correction of the rotational metatarsal head deformity and reduction of the sesamoid bones. We sought to determine the optimal method for sesamoid bone reduction during HV surgery.

Methods

We reviewed the medical records of 53 patients who underwent HV surgery between 2017 and 2019 using one of three techniques: open chevron osteotomy (n = 19), minimally invasive V-shaped osteotomy (n = 18), and a modified straight minimally invasive osteotomy (n = 16). The sesamoid position was graded using the Hardy and Clapham method on weight-bearing radiographs.

Results

When compared to open chevron and V-shaped osteotomies, the modified osteotomy resulted in significantly lower postoperative sesamoid position scores (3.74 ± 1.48, 4.61 ± 1.09, and 1.44 ± 0.81, respectively, P < 0.001). Furthermore, the mean change in postoperative sesamoid position score was greater (P < 0.001).

Conclusion

The modified minimally invasive osteotomy was superior to the other two techniques in correcting HV deformity in all planes, including sesamoid reduction.
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Metadata
Title
A modified minimally invasive osteotomy for hallux valgus enables reduction of malpositioned sesamoid bones
Authors
Ezequiel Palmanovich
Nissim Ohana
Alex Tavdi
Ran Atzmon
Viktor Feldman
Yaron S. Brin
Meir Nyska
David Segal
Publication date
18-05-2023
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 10/2023
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-023-04868-0

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