Assessment of Medial Eminence Resection Timing in Hallux Valgus Surgery Using Patient-Specific Three-Dimensional...

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• 3D modeling in medicine

Background:

• Distal chevron metatarsal osteotomy (DCMO) is a standard procedure for hallux valgus (HV) correction.
• The impact of medial eminence resection timing on surgical outcomes is not well-established.
• Understanding this timing is crucial for optimizing lateral translation, angular correction, and osteotomy stability.

Purpose of the Study:

• To investigate how the timing of medial eminence resection affects lateral translation, angular correction, and osteotomy contact area during DCMO.
• To compare surgical outcomes based on whether resection occurs before or after osteotomy.
• To evaluate the influence of different lateral translation strategies on these parameters.

Main Methods:

• Utilized patient-specific 3D-printed first metatarsal models derived from CT scans of 14 HV patients.
• Simulated DCMO across four groups, varying medial eminence resection timing and lateral translation methods.
• Measured osteotomy contact area and first metatarsal axis change angle (MACA) for comparative analysis.

Main Results:

• Delaying resection post-osteotomy significantly increased osteotomy contact area under fixed 7 mm translation (236.50 vs. 201.07 mm²).
• When preserving 5 mm contact width, delayed resection yielded greater angular correction (MACA: 20.71° vs. 15.36°).
• Comparable osteotomy contact area was maintained with delayed resection and limited translation.

Conclusions:

• Postponing medial eminence resection until after DCMO can enhance lateral translation and angular correction.
• This surgical timing strategy may improve hallux valgus correction while preserving osteotomy stability.
• Optimizing resection timing offers a potential improvement in DCMO outcomes for HV treatment.