Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Oct;143(10):6105-6112.
doi: 10.1007/s00402-023-04868-0. Epub 2023 May 18.

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

Ezequiel Palmanovich  1 , Nissim Ohana  2 , Alex Tavdi  2 , Ran Atzmon  3 , Viktor Feldman  2 , Yaron S Brin  2 , Meir Nyska  4 , David Segal  2
Affiliations
Review

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

Ezequiel Palmanovich et al. Arch Orthop Trauma Surg. 2023 Oct.

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.

Keywords: Distal metatarsal osteotomy; Hallux valgus; Metatarsal sesamoid bones; Minimally invasive chevron and akin.

PubMed Disclaimer

References

    1. De Prado M (2011) Minimally invasive foot surgery: a paradigm shift. Minimally invasive surgery of the foot and ankle. Springer, London, pp 3–11
    1. Ferrari J, Higgins JPT, Prior TD (2004) Interventions for treating hallux valgus (abducto valgus) and bunions. Cochrane Database Syst Rev 1:CD000964
    1. Fraissler L, Konrads C, Hoberg M, Rudert M, Walcher M (2016) Treatment of hallux valgus deformity. EFORT Open Rev Br Editor Soc Bone Jt Surg 1:295–302
    1. Knoth C, Carow L, Zettl R, Welter JE, Hess F (2016) Short- and long-term outcomes following hallux-valgus correction: a modified Kramer osteotomy. Arch Orthop Trauma Surg 136:1349–1355. https://doi.org/10.1007/s00402-016-2531-8 - DOI - PubMed
    1. Palmanovich E, Myerson MS (2014) Correction of moderate and severe hallux valgus deformity with a distal metatarsal osteotomy using an intramedullary plate. Foot Ankle Clin 19(2):191–201 - DOI - PubMed

LinkOut - more resources