Percutaneous Surgery for Tailor's Bunion: A Comparative Study

Objective  To analyze and compare the clinical and radiographic outcomes of bunionette correction using two percutaneous surgical techniques: the Sponsel technique and the medial wedge osteotomy of the distal metaphysis. The results were evaluated individually and comparatively using the American Orthopaedic Foot and Ankle Society's Lesser Metatarsophalangeal-Interphalangeal Scale (AOFAS), Visual Analog Scale (VAS) for pain assessment, and radiographic measurements of the intermetatarsal angle IV-V (AIM4-5) and metatarsophalangeal angle of the fifth ray (AMF-5). Methods  This was a retrospective study conducted from May 2011 to February 2022. A total of 32 feet were operated on, with 12 feet undergoing the Sponsel technique and 20 feet undergoing the medial wedge osteotomy of the distal metaphysis of the fifth metatarsal. Results  Both surgical techniques showed significant improvement in the correction of AIM4-5 and AMF-5 angles ( p  < 0.001). However, there was no statistical significance when comparing the two techniques. In terms of AOFAS and VAS scores, both techniques yielded satisfactory results. Nevertheless, the medial wedge osteotomy demonstrated significantly better outcomes compared with the Sponsel technique ( p  < 0.001). Conclusions  Both percutaneous techniques employed for bunionette correction resulted in significant improvement in radiographic angles and evaluated scores, with a low complication rate, making them viable options for treating this condition. When compared, the medial wedge osteotomy appeared to yield better clinical outcomes.