• Arch Orthop Trauma Surg · Oct 2023

    Review

    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, and David Segal.
    • 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. ezepalm@gmail.com.
    • Arch Orthop Trauma Surg. 2023 Oct 1; 143 (10): 610561126105-6112.

    BackgroundThe 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.MethodsWe 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.ResultsWhen 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).ConclusionThe modified minimally invasive osteotomy was superior to the other two techniques in correcting HV deformity in all planes, including sesamoid reduction.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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