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Bones of the Lower Limb: Tibia and Fibula01:10

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The tibia is the main weight-bearing bone of the lower leg. It is larger than the fibula with which it is paired. The tibia is also the second longest bone in the body and is located right below the skin. The proximal end of the tibia forms the medial and the lateral condyle, which articulates with the condyles of the femur to form the knee joint. Between the articulating surfaces is the irregular elevated area known as the intercondylar eminence that serves as the inferior attachment point for...
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Related Experiment Video

Updated: May 6, 2026

An Anatomical Study of Nerves at Risk During Minimally Invasive Hallux Valgus Surgery
15:04

An Anatomical Study of Nerves at Risk During Minimally Invasive Hallux Valgus Surgery

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Fourth-Generation Percutaneous Transverse Osteotomies for Hallux Valgus.

P Lam1, E P Murphy1, M J Chua2

  • 1Orthopaedic and Arthritis Specialist Centre, Chatswood, Sydney, Australia.

The Journal of Bone and Joint Surgery. American Volume
|August 25, 2025
PubMed
Summary

Fourth-generation percutaneous transverse osteotomy significantly improves hallux valgus deformity, with substantial gains in foot function and reduction in pain. This minimally invasive approach offers a low recurrence rate, enhancing patient outcomes.

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Area of Science:

  • Orthopedic surgery
  • Minimally invasive procedures
  • Foot and ankle reconstruction

Background:

  • Fourth-generation percutaneous transverse osteotomy is a minimally invasive technique for hallux valgus correction.
  • Limited studies with methodological limitations exist on transverse osteotomies.
  • This study aimed to robustly investigate percutaneous transverse osteotomies for hallux valgus.

Purpose of the Study:

  • To evaluate the clinical and radiographic outcomes of fourth-generation percutaneous transverse osteotomies for hallux valgus.
  • To provide a methodologically sound investigation of this surgical technique.

Main Methods:

  • Prospective study of consecutive patients undergoing percutaneous transverse osteotomy by a single surgeon.
  • Clinical outcomes assessed via Manchester-Oxford Foot Questionnaire (MOXFQ) and visual analog scale for pain.
  • Radiographic outcomes included hallux valgus angle (HVA), 1-2 intermetatarsal angle (IMA), and sesamoid position.

Main Results:

  • Significant improvements observed in HVA (29.5° to 7.3°) and IMA (12.9° to 4.6°).
  • All MOXFQ domains showed significant improvement (p < 0.05), including MOXFQ Index, Pain, Walking/Standing, and Social Interaction.
  • Low recurrence rate of 4.5% and complication rate of 6.1%.

Conclusions:

  • Fourth-generation percutaneous transverse osteotomy is effective for hallux valgus correction.
  • The study represents the largest consecutive series evaluating this technique.
  • Significant clinical and radiographic improvements were achieved with a low recurrence rate.