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Updated: Jul 6, 2026
An Anatomical Study of Nerves at Risk During Minimally Invasive Hallux Valgus Surgery
Published on: February 17, 2018
Percutaneous distal metatarsal osteotomy with K-wire fixation into the medial cuneiform for hallux valgus: A case
Yoshiharu Shimozono1, Shigeo Yoshida2, Yasuyuki Mizuno2
1Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Orthopaedic Surgery, Kyoto Shimogamo Hospital, Kyoto, Japan.
Background:
Minimally invasive surgery for hallux valgus is evolving, but the optimal fixation method and its applicability to severe deformity remain debated. We describe a percutaneous distal metatarsal osteotomy (PDMO) using a Shannon burr, lateral soft-tissue release, and a 2.0-mm Kirschner wire crossing the first tarsometatarsal joint into the medial cuneiform, allowing immediate flat-sole weight-bearing.
Methods:
Thirty-four patients (36 feet) were retrospectively reviewed. Hallux valgus angle (HVA), intermetatarsal angle (IMA), Self-Administered Foot Evaluation Questionnaire (SAFE-Q), and complications were analyzed; severe deformity (HVA ≥40°; n = 20) was examined separately.
Results:
HVA improved from 37.8 to 5.7° and IMA from 16.1 to 5.3° (both p < 0.001). All SAFE-Q subscales improved. In severe deformity, HVA improved to 6.3° with comparable gains. No recurrence occurred; complications were 4 of 36 (11.1%), all minor.
Conclusions:
This PDMO technique produced satisfactory correction and significant SAFE-Q improvement while permitting immediate flat-sole weight-bearing, including in severe deformity.
Level Of Evidence:
Level IV, case series.
