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

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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)6105-6112
Number of pages8
JournalArchives of Orthopaedic and Trauma Surgery
Volume143
Issue number10
DOIs
StatePublished - Oct 2023

Keywords

  • Distal metatarsal osteotomy
  • Hallux valgus
  • Metatarsal sesamoid bones
  • Minimally invasive chevron and akin

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