Anatomical Structures at Risk in Percutaneous Distal Bunionette Correction

Area of Science:

• Orthopedic Surgery
• Anatomy
• Minimally Invasive Procedures

Background:

• Bunionette deformity affects nearly 25% of the population, necessitating various corrective techniques.
• Percutaneous osteotomy is an emerging trend for bunionette correction.
• Anatomical considerations are vital for different osteotomy sites.

Purpose of the Study:

• To evaluate the anatomical structures at risk during percutaneous distal osteotomy of bunionette deformity using a Shannon burr.
• To assess potential damage to critical nerves and tendons during the procedure.

Main Methods:

• The study utilized 11 fresh cadaver specimens.
• A Shannon burr was used for distal osteotomy of the fifth metatarsal.
• Dissections were performed to identify and measure distances to the lateral dorsal cutaneous nerve (LDCN), abductor digiti minimi (ADM), and extensor digitorum longus (EDL).

Main Results:

• The osteotomy site was, on average, over 8 mm from the EDL and ADM.
• The average distance from the osteotomy site to the LDCN was 1.64 mm.
• The LDCN was contacted and transected in 2 instances during the cadaveric study.

Conclusions:

• Percutaneous distal osteotomy for bunionette deformity presents anatomical challenges, particularly concerning the LDCN.
• Minimally invasive approaches require careful anatomical assessment and cautious technique due to potential nerve injury.
• Variations in LDCN anatomy may increase surgical risk.