Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Orthopaedics
Published in: International Orthopaedics 9/2013

01-09-2013 | Original Paper

A minimally invasive technique for surgical treatment of hallux valgus: simple, effective, rapid, inexpensive (SERI)

Authors: Sandro Giannini, Cesare Faldini, Matteo Nanni, Alberto Di Martino, Deianira Luciani, Francesca Vannini

Published in: International Orthopaedics | Issue 9/2013

Login to get access

Abstract

Purpose

Several bony and soft tissue procedures have been described for the treatment of hallux valgus, and currently mini-invasive surgical techniques are preferred in order to reduce surgical trauma, complications, time of surgery and to allow an earlier recovery. The aim of this study is to analyse a series of 1,000 consecutive cases of hallux valgus, surgically treated by the minimally invasive SERI technique, reporting results at mid-term follow-up.

Methods

We prospectively studied 641 patients (1,000 feet) with symptomatic hallux valgus surgically treated by SERI osteotomy. Inclusion criteria were: age between 20 and 65 years, reducible mild or moderate hallux valgus, HVA ≤ 40°, IMA ≤ 20°, and arthritis of the first metatarsophalangeal joint up to grade 2 according to the Regnauld classification.

Results

The American Orthopaedic Foot and Ankle Society (AOFAS) score rose from 46.8 ± 16.7 preoperatively to 89 ± 10.3 at last follow-up. Radiographic control at follow-up showed a complete healing of the osteotomy and remodelling of the metatarsal bone. Low rate of complication has been reported.

Conclusions

This study demonstrated that the SERI technique is effective in treating mild to moderate hallux valgus in terms of relief from symptoms and functional improvement. This technique allowed correction of the main parameters of the deformity, with durable clinical and radiographic results at a mid-term follow-up.
Appendix
Available only for authorised users
Literature
1.
Coughlin MJ (1996) Hallux valgus. J Bone Joint Surg Am 78:932–966PubMed
2.
Hardy RH, Clapham JCR (1951) Observations on hallux valgus; based on a controlled series. J Bone Joint Surg Br 33:376–391PubMed
3.
4.
5.
Piqué-Vidal C, Solé MT, Antich J (2007) Hallux valgus inheritance: pedigree research in 350 patients with bunion deformity. J Foot Ankle Surg 46:149–154PubMedCrossRef
6.
Barnicot NA, Hardy RH (1955) The position of the hallux in West Africans. J Anat 89:355–361PubMed
7.
Barouk LS, Diebold P (1991) Hallux valgus congenital. Med Chir Pied 7:65–112
8.
Coughlin MJ, Jones CP (2007) Hallux valgus: demographics, etiology, and radiographic assessment. Foot Ankle Int 28:759–777PubMedCrossRef
9.
Devos Bevernage B, Leemrijse T (2009) Hallux varus: classification and treatment. Foot Ankle Clin 14:51–65PubMedCrossRef
10.
Dragonetti L (1997) Inquadramento eziopatogenetico e clinico dell’alluce abdotto-valgo. In: Malerba F, Dragonetti L, Giannini S (eds) Progressi in Medicina e Chirurgia del Piede. L’Alluce Valgo. Aulo Gaggi Editore, Bologna, pp 155–165
11.
Easley ME, Trnka HJ (2007) Current concepts review: hallux valgus part I: pathomechanics, clinical assessment, and nonoperative management. Foot Ankle Int 28:654–659PubMedCrossRef
12.
Engle E, Morton DJ (1931) Notes of foot disorders among natives of the Belgian Congo. J Bone Joint Surg Am 13:311–319
13.
James CS (1939) Footprints and feet of natives of Soloman Island. Lancet 2:1390–1393CrossRef
14.
Johnston O (1956) Further studies of the inheritance of hand and foot anomalies. Clin Orthop Relat Res 8:146–160
15.
Hohmann G (1925) Der Hallux Valgus und die übrigen Zehenverkrümmungen. Ergeb Chir Orthop 18:308–376CrossRef
16.
Mann RA, Coughlin MJ (1999) Adult hallux valgus. In: Coughlin MJ, Mann RA (eds) Surgery of the foot and ankle. Mosby, St. Louis, pp 150–269
17.
Pontius J, Kieran D, Mahan T, Carter S (1994) Characteristics of adolescent hallux abductus-valgus. A retrospective review. J Am Podiatr Med Assoc 84:208–218
18.
Root ML, Orien WP, Weed JH (2001) Deformità dell’avampiede causate dall’anomala pronazione della sottoastragalica. In: Root ML, Orien WP, Weed JH (eds) La fuzionalità del piede normale e patologico. Piccin, Padova, pp 333–435
19.
Sim-Fook L, Hodgson AR (1958) A comparison of foot forms among the non-shoe and shoe-wearing Chinese population. J Bone Joint Surg Am 40:1058–1062PubMed
20.
Veri JP, Pirani SP, Claridge R (2001) Crescentic proximal metatarsal osteotomy for moderate to severe hallux valgus: a mean 12.2 year follow-up study. Foot Ankle Int 22:817–822PubMed
21.
Austin DW, Leventen EO (1981) A new osteotomy for hallux valgus: a horizontally directed “V” displacement osteotomy of the metatarsal head for hallux valgus and primus varus. Clin Orthop Relat Res 157:25–30PubMed
22.
Bosch P, Markowski H, Rannicher V (1990) Technik und erste Ergebnisse der subkutanen distalen Metatarsale-I-Osteotomie. Orthopaedische Praxis 26:51–56
23.
24.
Chang JT (2001) Distal metaphyseal osteotomies in hallux abducto valgus surgery. In: Banks AS, Downey MS, Martin DE, Miller SJ (eds) McGlamry’s comprehensive textbook of foot and ankle surgery. Lippincott, Williams & Wilkins, Philadelphia, pp 505–527
25.
Coetzee JC, Wickum D (2004) The Lapidus procedure. A prospective cohort outcome study. Foot Ankle Int 25:526–531PubMed
26.
Corte-Real NM, Moreira RM (2009) Modified biplanar chevron osteotomy. Foot Ankle Int 30:1149–1153PubMedCrossRef
27.
Chuckpaiwong B (2012) Comparing proximal and distal metatarsal osteotomy for moderate to severe hallux valgus. Int Orthop 36:2275–2278PubMedCrossRef
28.
Fuhrmann RA, Zollinger-Kies H, Kundert HP (2010) Mid-term results of Scarf osteotomy in hallux valgus. Int Orthop 34:981–989PubMedCrossRef
29.
Giannini S, Ceccarelli F, Bevoni R, Vannini F (2003) Hallux valgus surgery: the minimally invasive bunion correction (SERI). Tech Foot Ankle Surg 2:11–20CrossRef
30.
Groulier P, Curvale G (1992) Postoperative iatrogenic hallux varus. Surgical treatment. Rev Chir Orthop Reparatrice Appar Mot 78:449–455PubMed
31.
Jawish R, Assoum H, Saliba E (2010) Opening wedge osteotomy of the first cuneiform for the treatment of hallux valgus. Int Orthop 34:361–368PubMedCrossRef
32.
Kadakia AR, Smerek JP, Myerson MS (2007) Radiographic results after percutaneous distal metatarsal osteotomy for correction of hallux valgus deformity. Foot Ankle Int 28:355–360PubMedCrossRef
33.
Lamprecht E (1996) Die retrokapitale Metatarsale-I-Osteotomie nach Kramer zur Behandlung des Hallux valgus. In: Meyer RP, Kappeler U (eds) Fußchirurgie in der Praxis. Springer-Verlag Berlin Heidelberg, Germany, pp 145–157CrossRef
34.
Lucijanic I, Bicanic G, Sonicki Z, Mirkovic M, Pecina M (2009) Treatment of hallux valgus with three-dimensional modification of Mitchell's osteotomy: technique and results. J Am Podiatr Med Assoc 99:162–172PubMed
35.
Magerl F (1982) Stabile Osteotomien zur Behandlung des Hallux valgus und Metatarsale I varum. Orthopade 11:170–180PubMed
36.
Magnan B, Pezzè L, Rossi N, Bartolozzi P (2005) Percutaneous distal metatarsal osteotomy for correction of hallux valgus. J Bone Joint Surg Am 86:1191–1199CrossRef
37.
Mitchell CL, Fleming JL, Allen R, Glenney C, Sanford G (1958) Osteotomy-bunionectomy for hallux valgus. J Bone Joint Surg Am 40:41–58PubMed
38.
Nery CAB, Barroco RUB, Ressio C (2002) Biplanar chevron osteotomy. Foot Ankle Int 23:792–798PubMed
39.
Sanna P, Ruiu GA (2005) Percutaneous distal osteotomy of the first metatarsal (PDO) for the surgical treatment of hallux valgus. Chir Organi Mov 90:365–369PubMed
40.
Trnka HJ, Zembsch A, Wiesauer H, Hungerford M, Salzer M, Ritschl P (1997) Modified Austin procedure for correction of hallux valgus. Foot Ankle Int 18:119–127PubMedCrossRef
41.
Wilson JN (1963) Oblique displacement osteotomy for hallux valgus. J Bone Joint Surg Br 45:552–556PubMed
42.
Pinney SJ, Song KR, Chou LB (2006) Surgical treatment of mild hallux valgus deformity: the state of practice among academic foot and ankle surgeons. Foot Ankle Int 27:970–973PubMed
43.
Pinney SJ, Song KR, Chou LB (2006) Surgical treatment of severe hallux valgus: the state of practice among academic foot and ankle surgeons. Foot Ankle Int 27:1024–1029PubMed
44.
Maffulli N, Longo UG, Oliva F, Denaro V, Coppola C (2009) Bosch osteotomy and scarf osteotomy for hallux valgus correction. Orthop Clin N Am 40:515–524CrossRef
45.
Myerson MS (2000) Hallux valgus. In: Myerson MS (ed) Foot and ankle disorders. WB Saunders, Philadelphia, pp 213–285
46.
Wulker N (2005) Hallux valgus: distal first metatarsal osteotomy. In: Wulker N, Stephens MM, Cracchiolo A (eds) An atlas of foot and ankle surgery. Taylor & Francis, Abingdon, pp 9–17CrossRef
47.
Nikolaou VS, Korres D, Xypnitos F, Lazarettos J, Lallos S, Sapkas G, Efstathopoulos N (2009) Fixation of Mitchell’s osteotomy with bioabsorbable pins for treatment of hallux valgus deformity. Int Orthop 33:701–706PubMedCrossRef
48.
Park CH, Ahn JY, Kim YM, Lee WC (2013) Plate fixation for proximal chevron osteotomy has greater risk for hallux valgus recurrence than Kirschner wire fixation. Int Orthop 37(6):1085–1092
49.
Grace DL (1987) Metatarsal osteotomy: which operation? J Foot Surg 82:501–506
50.
Giannini S, Faldini C, Vannini F, Digennaro V, Bevoni R, Luciani D (2008) The minimally invasive osteotomy “S.E.R.I”. (simple, effective, rapid, inexpensive) for correction of bunionette deformity. Foot Ankle Int 29:282–286PubMedCrossRef
51.
Giannini S, Faldini C, Vannini F, Cadossi M, Luciani D (2001) The minimally invasive hallux valgus correction (SERI). In: Wiesel SW (ed) Operative technique in orthopaedic surgery. Lippincott, Williams & Wilkins, Philadelphia, pp 3505–3511
52.
Regnauld B (1986) Hallux rigidus. In: Elson R (ed) The foot. Springer, Berlin, pp 335–350CrossRef
53.
Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M (1994) Clinical rating system for the ankle-hindfoot, midfoot, hallux and lesser toes. Foot Ankle Int 15:349–353PubMedCrossRef
54.
Coughlin MJ, Saltzman CL, Nunley JA (2002) Angular measurements in the evaluation of hallux valgus deformities: a report of the Ad Hoc Committee of the American Orthopaedic Foot and Ankle Society on angular measurements. Foot Ankle Int 23:68–74PubMed
55.
Smith RW, Reynolds JC, Stewart MJ (1984) Hallux valgus assessment: report of research committee of American Orthopaedic Foot and Ankle Society. Foot Ankle 5:92–103PubMedCrossRef
56.
Okuda R, Kinoshita M, Yasuda T, Jotoku T, Kitano N, Shima H (2009) Postoperative incomplete reduction of the sesamoids as a risk factor for recurrence of hallux valgus. J Bone Joint Surg Am 91:1637–1645PubMedCrossRef
57.
Coughlin MJ (1997) Hallux valgus in men: effect of the distal metatarsal articular angle on hallux valgus correction. Foot Ankle Int 18:463–470PubMedCrossRef
58.
Giannini S, Cavallo M, Faldini C, Luciani D, Vannini F (2013) The SERI distal metatarsal osteotomy and scarf osteotomy provide similar correction of hallux valgus. Clin Orthop Relat Res 471(7):2305–2311
59.
Easley ME, Trnka HJ (2007) Current concepts review: hallux valgus part II: operative treatment. Foot Ankle Int 28:748–758PubMedCrossRef
60.
Coughlin MJ, Freund E, Roger A (2001) Mann award. The reliability of angular measurements in hallux valgus deformities. Foot Ankle Int 22:369–379PubMed
61.
Saltzman CL, Brandser EA, Berbaum KS, DeGnore L, Holmes JR, Katcherian DA, Teasdall RD, Alexander IJ (1994) Reliability of standard foot radiographic measurements. Foot Ankle Int 15:661–665PubMedCrossRef
62.
Schneider W, Csepan R, Knahr K (2003) Reproducibility of the radiographic metatarsophalangeal angle in hallux surgery. J Bone Joint Surg Am 85:494–499PubMed
63.
Chi TD, Davitt J, Younger A, Holt S, Sangeorzan BJ (2002) Intra- and inter-observer reliability of the distal metatarsal articular angle in adult hallux valgus. Foot Ankle Int 23:722–726PubMed
64.
Oliva F, Longo UG, Maffulli N (2009) Minimally invasive hallux valgus correction. Orthop Clin N Am 40:525–530CrossRef
65.
66.
Belczyk R, Stapleton JJ, Grossman JP, Zgonis T (2009) Complications and revisional hallux valgus surgery. Clin Podiatr Med Surg 26:475–484PubMedCrossRef
67.
68.
Okuda R, Kinoshita M, Morikawa J, Jotoku T, Abe M (2001) Surgical treatment for hallux valgus with painful plantar callosities. Foot Ankle Int 22:203–208PubMed
69.
Vora AM, Myerson MS (2005) First metatarsal osteotomy nonunion and malunion. Foot Ankle Clin 10:35–54PubMedCrossRef
70.
Weil LS (2000) Scarf osteotomy for correction of hallux valgus. Historical perspective, surgical technique, and results. Foot Ankle Clin 5:559–580PubMed
71.
Resch S, Stenstrom A, Gustafson T (1992) Circulatory disturbance of the first metatarsal head after chevron osteotomy as shown by bone scintigraphy. Foot Ankle 13:137–142PubMedCrossRef
72.
Kuhn MA, Lippert FG 3rd, Phipps MJ, Williams C (2005) Blood flow to the metatarsal head after chevron bunionectomy. Foot Ankle Int 26:526–529PubMed
73.
Goldman FD, Siegel J (1993) Extensor hallucis longus tendon transfer for correction of hallux varus. J Foot Ankle Surg 32:126–131PubMed
74.
Dhillon MS, Bali K, Prabhakar S (2011) Controversies in calcaneus fracture management: a systematic review of the literature. Musculoskelet Surg 95:171–181PubMedCrossRef
75.
Hawkins FB (1971) Acquired hallux valgus: cause, prevention and correction. Clin Orthop Relat Res 76:169–176PubMedCrossRef
Metadata
Title
A minimally invasive technique for surgical treatment of hallux valgus: simple, effective, rapid, inexpensive (SERI)
Authors
Sandro Giannini
Cesare Faldini
Matteo Nanni
Alberto Di Martino
Deianira Luciani
Francesca Vannini
Publication date
01-09-2013
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 9/2013
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-013-1980-8

Other articles of this Issue 9/2013

International Orthopaedics 9/2013 Go to the issue

Review Article

The Ludloff osteotomy: a review of current concepts

Original Paper

Midterm results of the Ponseti method in the treatment of congenital clubfoot

Review Article

Hallux valgus and hypermobility of the first ray: facts and fiction

Editorial

Update in foot and ankle surgery

Original Paper

Proximal opening wedge metatarsal osteotomy for correction of moderate to severe hallux valgus deformity using a locking plate

Original Paper

The Weil osteotomy for correction of the severe rheumatoid forefoot