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[Minimally invasive forefoot surgery: concept and techniques].

N Harrasser1,2, A Toepfer3

  • 1Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland. norbert.harrasser@mri.tum.de.

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Summary

Minimally invasive surgery (MIS) offers effective solutions for forefoot deformities, including the first ray and lesser toes. These advanced techniques provide excellent clinical outcomes with reduced complications compared to traditional open surgeries.

Keywords:
Hallux valgusHammer toeMetatarsalgiaMinimally invasive Chevron and Akin osteotomyPercutaneous foot surgery

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Area of Science:

  • Orthopedic Surgery
  • Foot and Ankle Surgery
  • Minimally Invasive Procedures

Context:

  • Minimally invasive surgery (MIS) is increasingly established for forefoot deformity correction.
  • Traditional open procedures can involve significant complications and longer recovery times.

Purpose:

  • To evaluate the efficacy and indications of various minimally invasive surgical techniques for forefoot deformities.
  • To compare the outcomes of minimally invasive approaches with classical open surgical methods.

Summary:

  • Minimally invasive chevron and Akin osteotomy (MICA) demonstrates excellent clinical results for first ray deformities, offering broader indications than classical chevron osteotomy.
  • Minimally invasive treatment for hallux rigidus yields results comparable to open techniques, requiring careful patient selection.
  • Lesser toe deformities are effectively managed with minimally invasive osteotomy, capsule release, and tendon lengthening, often avoiding internal fixation.
  • Distal metatarsal osteotomy shows a lower rate of cock-up deformities and avoids internal fixation compared to the Weil osteotomy.

Impact:

  • Minimally invasive approaches represent a valuable alternative to open surgery for forefoot deformities.
  • These techniques are associated with a reduced incidence of wound healing complications and postoperative pain.
  • MIS offers potential for improved patient recovery and satisfaction in foot and ankle surgery.