Percutaneous, MIS and open hallux valgus surgery.

Area of Science:

• Orthopedic Surgery
• Surgical Techniques
• Foot and Ankle Surgery

Background:

• Confusion exists regarding terminology for minimally invasive surgery (MIS) and percutaneous surgery.
• MIS encompasses a spectrum from percutaneous to open surgery, with distinct generations of techniques.
• Hallux valgus correction involves various osteotomy types and surgical approaches.

Purpose of the Study:

• To clarify terminology distinguishing percutaneous surgery from minimally invasive surgery (MIS).
• To review and compare different generations of MIS hallux valgus surgery techniques.
• To evaluate clinical and radiological outcomes of MIS versus open hallux valgus correction.

Main Methods:

• Literature review of percutaneous and minimally invasive hallux valgus surgical techniques.
• Classification of MIS hallux valgus surgery into first, second, and third generations.
• Comparison of outcomes for Isham, Bösch, SERI, and chevron/SCARF osteotomies.

Main Results:

• First-generation MIS (Isham) is suitable for minor deformities.
• Second-generation MIS (Bösch, SERI) reports up to 61% malunion rates.
• Third-generation MIS (chevron osteotomies) can achieve outcomes comparable to open surgery after a learning curve.

Conclusions:

• Percutaneous surgery is defined as 'made through the skin'; MIS is a broader term.
• Minimally invasive and percutaneous hallux valgus correction show comparable results to open osteotomies.
• Specialized cadaveric training is essential for surgeons performing MIS techniques.