Fourth-Generation Minimally Invasive Hallux Valgus Surgery With Metaphyseal Extra-Articular Transverse and Akin...

Area of Science:

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

Background:

• Fourth-generation minimally invasive surgery (MIS) utilizes multiplanar rotational correction via extra-articular distal first metatarsal osteotomy.
• Rigid fixation with two fully threaded screws, including one bicortical screw, ensures rotational and biomechanical stability.

Purpose of the Study:

• To evaluate the clinical and radiographic outcomes of an advanced fourth-generation MIS hallux valgus technique.
• To assess the effectiveness of this evolved surgical approach in correcting foot deformities.

Main Methods:

• A prospective single-surgeon study included consecutive patients undergoing fourth-generation MIS with a minimum 12-month follow-up.
• Outcomes were assessed using the Manchester-Oxford Foot Questionnaire (MOXFQ), radiographic measurements, and EuroQol-5D-5L (EQ-5D-5L) quality of life assessments.

Main Results:

• Fifty feet were treated with fourth-generation MIS, showing significant improvements in all MOXFQ domains (index from 53.4 to 13.1, P < .001).
• Radiographic improvements included significant reductions in hallux valgus angle (32.7° to 7.9°), intermetatarsal angle (14.0° to 4.2°), and distal metatarsal articular angle (18.5° to 5.6°), all with P < .001.
• Patient-reported quality of life also significantly improved, with gains in EQ-5D-5L index and EQ-VAS scores (P < .05).

Conclusions:

• The evolved fourth-generation MIS technique is a safe and effective method for correcting hallux valgus deformities.
• This approach leads to substantial improvements in both clinical function and radiographic alignment.