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Third-generation minimally invasive correction of hallux valgus: technique and early outcomes

International Orthopaedics volume 38, pages 2115–2121 (2014)Cite this article

Abstract

Purpose

There is growing evidence supporting minimally invasive surgical (MIS) techniques for correction of symptomatic hallux valgus. The aim of this study was to present a hybrid third-generation technique and assess the safety and efficacy from the first 45 procedures.

Methods

Forty-five consecutive feet underwent a third-generation MIS distal chevron osteotomy with a minimum six month follow-up (range six to 17 months). This technique uses both first- and second-generation techniques plus a distal chevron osteotomy and screw for improved control and stabilisation of the metatarsal head. All patients were clinically assessed using the Manchester–Oxford Foot Questionnaire (MOXFQ). Radiographic measures included hallux valgus angle (HVA), intermetatarsal angle (IMA), first metatarsal length and overall toe length.

Results

There were significant improvements in all three domains of the MOXFQ (p <0.001). There was also significant improvement in all radiographic parameters (p < 0.001). Mean HVA decreased from 30.54° to 10.41°, and the mean IMA decreased from 14.55° to 7.11°. Shortening of the first metatarsal had no effect on clinical outcomes. There was a very low rate of complications.

Conclusion

The short-term results of this third-generation technique show that it is a safe procedure with good clinical outcomes and compares favourably with earlier techniques.

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Affiliations

  1. Department of Orthopaedics, Western Sussex NHS trust, Worthing Hospital, Worthing, BN11 2DH, UK

    Kit Brogan, Tom Voller, Chris Gee & Simon Palmer

  2. School of Psychology, University of Sussex, Brighton, BN1 9QH, UK

    Tamas Borbely

Authors
  1. Kit Brogan
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  2. Tom Voller
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  3. Chris Gee
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  4. Tamas Borbely
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  5. Simon Palmer
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Correspondence to Kit Brogan.

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Brogan, K., Voller, T., Gee, C. et al. Third-generation minimally invasive correction of hallux valgus: technique and early outcomes. International Orthopaedics (SICOT) 38, 2115–2121 (2014). https://doi.org/10.1007/s00264-014-2500-1

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  • DOI: https://doi.org/10.1007/s00264-014-2500-1

Keywords

  • Hallux valgus
  • Bunion
  • Minimally invasive
  • MIS
  • Chevron