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

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2016

Open Access 01-12-2016 | Research article

Functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with Reverdin-Isham and Akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2016

Login to get access

Abstract

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. Clinical evaluation was assessed preoperatively, as well as at 3 and 12 months after surgery and at final follow-up of 48 months, using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux grading system. Patient satisfaction and complications were recorded. Computer-assisted measurement of antero-posterior radiographs was taken preoperatively, as well as at 3 and 12 months after surgery and at 48-month follow-up, analysing the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA) and the tibial sesamoid position. Also, the bridging bone/callus formation was evaluated at the different radiographic follow-ups, while the articular surface congruency and the metatarsal index were calculated only preoperatively and at the last follow-up. Patient satisfaction was assessed using the visual analogue score (VAS). Statistical analysis was carried out using the paired t test. Statistical significance was set at p < 0.05.

Results

The mean AOFAS score was 87.15 points at the final follow-up of 48 months, and the VAS score was 8.35/10. The post-operative radiographic assessments showed a statistically significant improvement compared with preoperative values. The mean corrections of each angular value at the last follow-up were as follows: IMA 3.90°, HVA 12.50°, DMAA 4.72° and a tibial sesamoid position of 1.10. The articular surface was congruent in 77 (96.25%) cases and incongruent only in 3 (3.75%). The complete healing of the osteotomies was achieved in all series at 3-month follow-up. However, the results obtained in the correction of the severe HV deformities were less encouraging.

Conclusions

Minimally invasive surgery with Reverdin-Isham and Akin percutaneous osteotomy, in combination with previous exostosectomy and subsequent lateral soft-tissue release, is a safe, effective and reliable procedure for correction of mild-to-moderate HV. However, it requires a long learning curve because of the inherent difficulty of the mixed different surgical procedures.

Trial registration

ClinicalTrials.gov PRS Protocol Registration and Results System: NCT02886221
Literature
1.
Mann RA, Coughlin MJ. Hallux valgus-etiology, anatomy, treatment and surgical considerations. Clin Orthop Relat Res. 1981;157:31–41.
2.
Root M, Orien W, Weed J. Normal and abnormal function of the foot, vol. 2. Los Angeles: Clinical Biomechanics Corp; 1977.
3.
Biz C, Favero L, Stecco C, Aldegheri R. Hypermobility of the first ray in ballet dancer. Mus Lig Tend J. 2012;2(4):282–8.
4.
Baravarian B, Brinski GB, Burns P. Lapidus bunionectomy: arthrodesis of the first metatarsocuneiform joint. Clin Podiatr Med Surg. 2004;21:97–111.CrossRefPubMed
5.
Richardson EG. Foot in adolescent and adults. In: Crenshaw AH, editor. Campbell’s operative orthopedics, vol. 2. 7th ed. St Louis: C.V. Mosby; 1992. p. 829–988.
6.
Stienstra JJ. Large displacement distal chevron osteotomy, for the correction of hallux valgus deformity. J Foot Ankle Surg. 2002;41:213–20.CrossRefPubMed
7.
Biz C, Corradin M, Petretta I, Aldegheri R. Endolog technique for correction of hallux valgus: a prospective study of 30 patients with 4-years follow-up. J Orthop Surg Res. 2015;10:102–15.CrossRefPubMedPubMedCentral
8.
Trnka HJ. Osteotomies for hallux valgus correction. Foot Ankle Clinics N Am. 2005;10:15–33.CrossRef
9.
Roukis TS. Percutaneous and minimum incision metatarsal osteotomies: a systematic review. J Foot Ankle Surg. 2009;48(3):380–7.CrossRefPubMed
10.
Bauer T, de Lavigne C, Biau D, De Prado M, Isham S, Laffenetre O. Percutaneous hallux valgus surgery: a multicenter study of a 189 cases. Orthop Clin N Am. 2009;40:505–14.CrossRef
11.
Dennis NZ, Das De S. Modified Mitchell’s osteotomy for moderate to severe hallux valgus—an outcome study. J Foot Ankle Surg. 2011;50:50–4.CrossRefPubMed
12.
Giannini S, Faldini C, Vannini F, Digennaro V, Bevoni R, Luciani D. The minimally invasive osteotomy “S.E.R.I.” (simple, effective, rapid, inexpensive) for correction of bunionette deformity. Foot Ankle Int. 2008;29(3):282–6.CrossRefPubMed
13.
Magnan B, Bortolazzi R, Samaila E, Pezzè L, Rossi N, Bartolozzi P. Percutaneous distal metatarsal osteotomy for correction of hallux valgus. Surgical technique. J Bone Joint Surg Am. 2006;88-A(suppl-1):135–48.CrossRef
14.
Siclari A, Decantis V. Arthroscopic lateral release and percutaneous distal osteotomy for hallux valgus: a preliminary report. Foot Ankle Int. 2009;30:675–9.CrossRefPubMed
15.
Maffulli N, Longo UG, Marinozzi A, Denaro V. Hallux valgus: effectiveness and safety of minimally invasive surgery. A systematic review. Br Med Bull. 2011;9:149–67.CrossRef
16.
De Prado M, Ripoll PL, Golano P. Minimally invasive foot surgery: surgical techniques, indications, anatomical basis. About your health, Spain. 2009. p. 63–123.
17.
Van Enoo RE, Cane EM. Minimal incision surgery: a plastic technique or a cover-up? Clin Podiatr Med Surg. 1986;3(2):321–35.PubMed
18.
Hymes L. Introduction: brief history of the use of minimum incision surgery (MIS). In forefoot minimum incision in podiatric medicine: a handbook on primary corrective procedures on the human foot using minimum incisions with minimum trauma. New York: Futura Publishing Co.; 1977.
19.
Isham SA. The Reverdin-Isham procedure for the correction of hallux abducto valgus. A distal metatarsal osteotomy procedure. Clin Podiatr Med Surg. 1991;8–1:81–94.
20.
de Prado M, Ripoll PL, Golanó P. Minimally invasive surgery. Barcelona: AYH Publisher; 2009. p. 3–123.
21.
22.
Laffenetre O, et al. Chirurgie par technique percutanée de l'avant-pied: hallux valgus, metatarsalgies, 5e rayon. In: Lemrijse T, Valtin B, editors. Pathologie du pie et de la cheville. Paris: Masson; 2009. p. 243–53.
23.
Magnan B, Samaila E, Merlini M, Bondi M, Mezzari S, Bartolozzi P. Percutaneous distal osteotomy of the fifth metatarsal for correction of bunionette. J Bone Joint Surg Am. 2011;93:2116–22.CrossRefPubMed
24.
De Prado M, Ripoll PL, Vaquero J, Golàno P. Tratamiento quirùrgico percutàneo del hallux valgus mediante osteotomias mùltiples. Rev Esp Cir Ortop Traumatol. 2003;47:406–16.
25.
Lucas y Hernandez J, Golanó P, Roshan-Zamir S, Darcel V, Chauveaux D, Laffenêtre O. Treatment of moderate hallux valgus by percutaneous, extra-articular reverse-L Chevron (PERC) osteotomy. Bone Joint J. 2016;98-B:365–73.CrossRefPubMed
26.
Laffenetre O, et al. 1st GRECMIP. Mini-invasive surgery of hallux valgus. In: Valtin B, Leemrijse T, editors. Chirurgie de l'avant-pied. 2nd ed. Paris: Elsevier; 2005. p. 96–104.
27.
Smith RW, Reynolds JC, Stewart MJ. Hallux valgus assessment: report of research committee of American Orthopaedic Foot and Ankle Society. Foot Ankle. 1984;5(2):92–103.CrossRefPubMed
28.
Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JR, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15:349–53.CrossRefPubMed
29.
Coughlin MJ, Mann RA, Saltzman CL. Surgery of the foot and ankle. 8th ed. Philadelphia: Mosby Elsevier; 2007. p. 184–19.
30.
Vernois J, Redfern D. Percutaneous Chevron: the union of classic stable fixed approach and percutaneous technique. Fuss Sprunggelenk. 2013;11:70–5.CrossRef
31.
Sullivan BT, Robison JB, Palladino SJ. Interevaluator variability in the measurement of proximal articular set angle. J Foot Surg. 1988;2:466–8.
32.
Shechter DZ, Doll PJ. Tangential angle to the second axis. A new angle with implications for bunion surgery. J Am Podiatr Med Assoc. 1985;75:505–12.CrossRefPubMed
33.
Bonnel F, Canovas F, Poierre G. Radiographical results of scarf osteotomy for hallux valgus related to distal metatarsal articular angle. Rev ChirOrthop. 1999;85:381–6.
34.
Nery C, Réssio C, de Azevedo Santa Cruz G, de Oliveira RS, Chertman C. Proximal opening-wedge osteotomy of the first metatarsal for moderate and severe hallux valgus using low profile plates. Foot Ankle Surg. 2013;19(4):276–82.CrossRefPubMed
35.
Bauer T, Biau D, Lortat-Jacob A, Hardy P. Percutaneous hallux valgus correction using the Reverdin-Isham osteotomy. Orthop Traumatol Surg Res. 2010;96:407–16.CrossRefPubMed
36.
de Lavigne C, Guillo S, Laffenetre O, et al. The treatment of hallux valgus with the mini-invasive technique. Interact Surg. 2007;2:31–7.CrossRef
37.
Vernois J. The treatment of the hallux valgus with a percutaneous chevron osteotomy. J Bone Joint Surg (Br). 2011;93-B(supp-IV):482.
38.
Faour-Martín O, Martín-Ferrero MA, Valverde García JA, Vega-Castrillo A, de la Red-Gallego MA. Long-term results of the retrocapital metatarsal percutaneous osteotomy for hallux valgus. Int Orthop. 2013;37:1799–803.CrossRefPubMedPubMedCentral
39.
Magnan B, Pezzè L, Rossi N, Bartolozzi P. Percutaneous distal metatarsal osteotomy for correction of hallux valgus. J Bone Joint Surg. 2005;87:1191–9.PubMed
40.
Deenik AR, Pilot P, Brandt SE, van Mameren H, Geesink RG, Draijer WF. Scarf versus chevron osteotomy in hallux valgus: a randomized controlled trial in 96 patients. Foot Ankle Int. 2007;28(5):537–41.CrossRefPubMed
41.
Gonzalez Lopez JJ, Rodriguez Rodriguez S. Functional, esthetic and radiographic results of treatment of hallux valgus with minimally invasive surgery. Acta Ortop Mex. 2005;19(1):S42–6.
42.
Maffulli N, Oliva F, Coppola C, Miller D. Minimally invasive hallux valgus correction: a technical note and a feasibility study. J Surg Orthop Adv. 2005;14:193–8.PubMed
43.
Kerr HL, Jackson R, Kothari P. Scarf-Akin osteotomy correction for hallux valgus: short-term results from a district general hospital. Foot Ankle Surg. 2010;49:16–9.CrossRef
44.
Maffulli N, Longo UG, Oliva F, Denaro V, Coppola C. Boschosteotomy and scarf osteotomy for hallux valgus correction. Orthop Clin North Am. 2009;40:515–24.CrossRefPubMed
45.
Meier PJ, Kenzora JE. The risks and benefits of distal first metatarsal osteotomies. Foot Ankle. 1985;6:7–17.CrossRefPubMed
46.
Laughlin TJ. Complications of distal first metatarsal osteotomies. Foot Ankle Surg. 1996;34:524–31.CrossRef
47.
Shamim M. Diathermy vs. scalpel skin incisions in general surgery: double-blind, randomized, clinical trial. World J Surg. 2009;33(8):1594–9.CrossRefPubMed
48.
Ly J, Mittal A, Windsor J. Systematic review and meta-analysis of cutting diathermy versus scalpel for skin incision. Br J Surg. 2012;99(5):613–20.CrossRefPubMed
49.
Sarrafian SK. A method of predicting the degree of functional correction of the metatarsus primus varus with a distal lateral displacement osteotomy in hallux valgus. Foot Ankle. 1985;5:322–6.CrossRefPubMed
50.
Badwey TM, Dutkowsky JP, Graves SC, Richardson EG. An anatomical basis for the degree of displacement of the distal chevron osteotomy in the treatment of hallux valgus. Foot Ankle Int. 1997;18(4):213–5.CrossRefPubMed
51.
Jones CP, Coughlin MJ, Grebing BR, Kennedy MP, Shurnas PS, Viladot R, Golanó P. First metatarsophalangeal joint motion after hallux valgus correction: a cadaver study. Foot Ankle Int. 2005;26:614–9.PubMed
52.
Okuda R, Kinoshita M. Postoperative incomplete reduction of the sesamoids as a risk factor for recurrence of hallux valgus. J Bone Joint Surg Am. 2009;91:1637–45.CrossRefPubMed
53.
Metadata
Title
Functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with Reverdin-Isham and Akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up
Publication date
01-12-2016
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2016
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-016-0491-x

Other articles of this Issue 1/2016

Journal of Orthopaedic Surgery and Research 1/2016 Go to the issue

Research article

Comparison of unilateral and bilateral percutaneous vertebroplasty for osteoporotic vertebral compression fractures: a systematic review and meta-analysis

Research article

Identification of candidate genes for myeloma-induced osteocyte death based on microarray data

Research article

Liposome bupivacaine for pain control after total knee arthroplasty: a meta-analysis

Research article

Influence of patient-related characteristics on early migration in calcar-guided short-stem total hip arthroplasty: a 2-year migration analysis using EBRA-FCA

Research article

A study on the clinical outcomes of patients with revision surgery for adjacent segment disease after 10-year’s anterior cervical spine surgery

Research article

Effect of whole-body vibration on reduction of bone loss and fall prevention in postmenopausal women: a meta-analysis and systematic review