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[Minimally invasive cheilectomy].

M Walther1, P Chomej2, S Kriegelstein3

  • 1Zentrum für Fuß- und Sprunggelenkchirurgie, Schön Klinik München Harlaching - FIFA Medical Centre, Harlachinger Straße 51, 81547, München, Deutschland. mwalther@schoen-kliniken.de.

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Summary
This summary is machine-generated.

This study presents a minimally invasive surgical technique for hallux rigidus, effectively removing dorsal osteophytes and resecting the metatarsal head to improve joint function. The procedure offers a soft-tissue-preserving approach with rapid patient rehabilitation and good functional outcomes.

Keywords:
Arthritis, degenerativeHallux rigidusMetatarsophalangeal jointMinimal access surgical proceduresOsteoarthritis

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Area of Science:

  • Orthopedic Surgery
  • Foot and Ankle Surgery
  • Musculoskeletal Research

Background:

  • Hallux rigidus is a degenerative condition affecting the first metatarsophalangeal joint.
  • Advanced stages (II and III) often require surgical intervention to alleviate pain and improve function.
  • Current treatments aim to preserve joint mobility while addressing bony deformities.

Purpose of the Study:

  • To evaluate a minimally invasive surgical technique for treating hallux rigidus (grades II and III).
  • To assess the efficacy of dorsal osteophyte resection, synovectomy, and partial metatarsal head resection.
  • To determine the functional outcomes and complication rates associated with this approach.

Main Methods:

  • A minimally invasive approach involving a small dorsomedial incision (1 cm) was utilized.
  • Dorsal osteophytes were resected, and the dorsal third of the metatarsal head was removed using a burr to enhance dorsiflexion.
  • Intraoperative arthroscopy was employed for assessment of bone resection and joint irrigation.

Main Results:

  • The technique demonstrated soft-tissue preservation and improved dorsiflexion.
  • A total of 38 patients (21 women, 17 men) with hallux rigidus grades II and III underwent the procedure.
  • The average American Orthopaedic Foot & Ankle Society (AOFAS) score at follow-up was 88.7, with a low complication rate (1 tendon injury, 2 revisions).

Conclusions:

  • Minimally invasive resection of dorsal osteophytes and partial metatarsal head resection is an effective treatment for moderate to severe hallux rigidus.
  • This technique facilitates limited soft-tissue trauma and promotes faster rehabilitation.
  • The procedure yields favorable functional outcomes with a low incidence of significant complications.