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

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

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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Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank Nitzan Konstantin and Cindy Cohen for their editorial assistance.

Funding

This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Orthopaedic Department, Meir Hospital, Sapir Medical Center, Kfar Saba, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 56 Tchernichovsky St., 4428164, Kfar Saba, Israel

    Ezequiel Palmanovich, Nissim Ohana, Alex Tavdi, Viktor Feldman, Yaron S. Brin & David Segal

  2. Assuta Medical Center, Department of Orthopaedic Surgery, Affiliated with the Faculty of Health and Science and Ben Gurion University, 7747629, Ashdod, Israel

    Ran Atzmon

  3. Orthopaedic Surgery Specialist, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Meir Nyska

Authors
  1. Ezequiel Palmanovich
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  2. Nissim Ohana
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  3. Alex Tavdi
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  4. Ran Atzmon
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  5. Viktor Feldman
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  6. Yaron S. Brin
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  7. Meir Nyska
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  8. David Segal
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Contributions

EP: study design, surgery, and preparation of the first draft of the manuscript. NO: critical review of the manuscript and interpretation. DS: statistical analysis, manuscript preparation, critical review. AT: statistical analysis. RA: manuscript critical review. YB , VF: data collection and review of the manuscript. NM: study design.

Corresponding author

Correspondence to Ezequiel Palmanovich.

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Conflict of interest

There are no competing interests to declare.

Ethical approval

All protocols were conducted per relevant guidelines and regulations, a statement confirming all the methods were approved by the Institutional Ethical Committee (Meir Medical Center Institutional Review Board). The study was approved by the Meir Medical Center Institutional Review Board.

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A waiver of informed consent was issued by the Meir Medical Center Institutional Review Board due to the retrospective nature of this study.

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Palmanovich, E., Ohana, N., Tavdi, A. et al. A modified minimally invasive osteotomy for hallux valgus enables reduction of malpositioned sesamoid bones. Arch Orthop Trauma Surg 143, 6105–6112 (2023). https://doi.org/10.1007/s00402-023-04868-0

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  • DOI: https://doi.org/10.1007/s00402-023-04868-0

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