A modified minimally invasive osteotomy for hallux valgus enables reduction of malpositioned sesamoid bones
Background: Current minimally invasive distal metatarsal osteotomy for hallux valgus (HV) is V-shaped, which prevents correcting the rotational metatarsal head deformity and reduction of sesamoid bones. We aimed to determine the optimal method for sesamoid bone reduction in HV surgery.
Methods: We reviewed the records of 53 patients who underwent HV surgery by a single surgeon from 2017 to 2019 according to 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). Sesamoid position was graded using the Hardy and Clapham method based on standing radiographs.
Results: Postoperative sesamoid position scores were significantly lower (better) following the modified osteotomy than following open chevron osteotomy and V-shaped osteotomy (1.44±0.81, 3.74±1.48 and 4.61±1.09, respectively, P<0.001); and the mean change in score was greater (P<0.001).
Conclusion: Modified minimally invasive osteotomy was superior to the two other techniques, in the correction of HV deformity in all planes, including sesamoid reduction.
Keywords:hallux valgus, distal metatarsal osteotomy, minimally invasive chevron and akin
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