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Distal Chevron Osteotomy vs The Simple, Effective, Rapid, Inexpensive Technique (SERI) for Mild to Moderate Isolated Hallux Valgus: A Randomized Controlled Study

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Abstract

Background

Hallux valgus is a common foot deformity that leads to functional disability with serious sequelae. Minimally invasive surgery is often used to treat hallux valgus in order to reduce wound complications and improve recovery time. The objective of this study was to compare a Simple, Effective, Rapid, Inexpensive (SERI) technique with a simple Chevron technique in patients with minimum of 1-year follow-up.

Methods and Materials

Between the years 2014–2015, we performed a prospective study comparing the SERI minimally invasive technique to treat symptomatic hallux valgus with a standard chevron osteotomy technique. All procedures were performed by a single fellowship trained foot and ankle surgeon. Twenty-one patients were randomized to the SERI cohort and 15 to the standard Chevron technique.

Results

The mean preoperative intermetatarsal angle (IMA) of the SERI group was 14.8 ± 1.9 (11.9–22.9). The mean preoperative IMA of the Chevron control group was 13.3 ± 2.3 (10.4–18.2) (p = 0.038). The mean IMA two weeks after the surgery was 6.0 ± 2.3 (2.4–12) in the SERI group, and 6.1 ± 3 (2.6–13.1) in the control group. At the two-week and 1-year follow-up, there was no significant difference found in the IMA between the two groups (p = 0.871). The mean hallux valgus angle reduction was 11.85 ± 4.88 (3–20.8) and 11.09 ± 6.51 (− 1.1 to 22.5) in the SERI and Chevron groups, respectively (p = 0.69). Neither groups reported symptomatic transfer metatarsalgia throughout the follow-up period. The SERI group had increased metatarsophalangeal joint (MTPJ) motion (p < 0.001); however, all other parameters with similar.

Conclusion

The SERI technique provided comparable outcomes at up to 1-year follow-up when compared with a standard Chevron osteotomy for moderate hallux valgus. This study demonstrated good reproducible results using the SERI technique for moderate hallux valgus.

Level of Evidence

Level II Prospective Study.

Trial Registration

Approved by local IRB at MMC.

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Abbreviations

AOFAS:

American Orthopedic Foot and Ankle Society

AP:

Anterior–posterior

AVN:

Avascular necrosis

DMAA:

Distal metatarsal articular angle

HVA:

Hallux valgus angle

IMA:

Intermetatarsal angle

KW:

Kirshner wire

MTPJ:

Metatarsophalangeal joint

OA:

Osteoarthritis

PDO:

Percutaneous distal metatarsal osteotomy

SERI:

Simple, effective, rapid, inexpensive

SSPS:

Statistical package for the social sciences

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Acknowledgements

We thank Mr. Nitzan Konstantin for assistance with writing the manuscript. All authors were fully involved in the study and preparation of the manuscript and that the material within has not been and will not be submitted for publication elsewhere.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Meir Medical Center, Affiliated with the Sackler Faculty of Medicine, Kfar Saba, Israel

    Ezequiel Palmanovich, N. Ohana, Segal David, I. Hetsroni & D. Segal

  2. Department of Orthopaedic Surgery, Tel Aviv Medical Center, Tel Aviv University, Affiliated with the Sackler Faculty of Medicine, Tel Aviv, Israel

    I. Small & E. Amar

  3. Department of Orthopaedic Surgery Montefiore, Bronx, NY, USA

    Z. T. Sharfman

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

    R. Atzmon

Authors
  1. Ezequiel Palmanovich
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  2. N. Ohana
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  3. Segal David
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  4. I. Small
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  5. I. Hetsroni
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  6. E. Amar
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  7. Z. T. Sharfman
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  8. D. Segal
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  9. R. Atzmon
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Contributions

EP and ON collected the data; EP, RA analyzed, and interpreted the X-ray images; EP, AR, ST, and HI were the major contributors in writing the manuscript; NO and AE reviewed the manuscript. All authors read and approved the final manuscript.

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Correspondence to Ezequiel Palmanovich.

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The authors declare that they have no competing interests.

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The study was approved by the local institutional review board.

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Palmanovich, E., Ohana, N., David, S. et al. Distal Chevron Osteotomy vs The Simple, Effective, Rapid, Inexpensive Technique (SERI) for Mild to Moderate Isolated Hallux Valgus: A Randomized Controlled Study. JOIO 55 (Suppl 1), 110–118 (2021). https://doi.org/10.1007/s43465-020-00209-0

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  • DOI: https://doi.org/10.1007/s43465-020-00209-0

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