[Translated article] A prospective case series: Results of fourth generation minimally invasive surgery (MIS) in...

and aim Surgical techniques that try to correct the three-dimensional deformity of hallux valgus is becoming more and more frequent with the hope of achieving better outcomes. The aim of this study was to assess the radiological parameters of correction in transverse and frontal planes as well as clinical outcomes of hallux valgus patients undergoing a 4th generation MIS technique.

Seventy-seven feet in 77 patients with hallux valgus deformity were treated with a 4th generation minimally invasive technique which allowed frontal plane correction with a follow up of 12 months. Preoperative and postoperative anteroposterior weightbearing X-ray images were analysed including hallux valgus angle, intermetatarsal angle, tibial sesamoid position and frontal plane first metatarsal rotation by means of a classification into four groups. Clinical outcomes were measured using the Visual Analog Scale (VAS), the American Orthopaedic Foot Ankle Society (AOFAS) hallux MTF-IF questionnaire, and EuroQol (EQ5D5L and EQVAS) prior to surgery and one year of follow-up.

There were statistical significant differences in the four radiological variables (p<0.001) with a mean correction of 23.5±9.6° in hallux valgus angle, 7.0±3.5° in intermetatarsal angle, 2.6±1.3 in tibial sesamoid position and a change of 1.4±0.9 in first metatarsal pronation classification. There was a significant improvement in all the clinical parameters measured. The complication rate was 18.8% and 2.6% required reoperation.

The proposed MIS technique has shown to be a potential method for correction of hallux valgus in the transverse and frontal plane with a low complication rate, patient satisfaction and an improvement in quality of life.