Association Between Minimally Invasive Osteotomy Techniques and Bunion Correction Outcomes

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery
• Minimally Invasive Procedures

Background:

• Minimally invasive surgery (MIS) for hallux valgus (HAV) aims to improve correction through techniques like medial eminence osteotomy.
• The medial eminence's role in enhancing lateral capital fragment translation for HAV correction requires further investigation.

Purpose of the Study:

• To investigate the correlation between osteotomy placement through the medial eminence and improved hallux valgus (HAV) and forefoot width (FW) correction.
• To identify radiographic parameters predictive of successful MIS bunion correction.

Main Methods:

• Retrospective analysis of 20 patients undergoing MIS bunion correction.
• Pre- and postoperative radiographs assessed hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), sesamoid position, osteotomy characteristics, capital fragment shift, and forefoot width.
• Pearson correlation and multivariable linear regression analyzed associations; one-year chart review for complications.

Main Results:

• Significant correlations observed between DMAA and HVA (r=0.883), DMAA and IMA (r=0.573), and HVA and capital fragment shift (r=0.541).
• Osteotomy location and angle were not significantly associated with correction outcomes.
• DMAA independently predicted HVA correction (β=0.679); capital fragment shift and metatarsal head angulation correlated with FW narrowing.
• No complications were reported in the cohort.

Conclusions:

• Medial eminence osteotomy in MIS bunion surgery was not associated with improved HAV or FW correction.
• Angular deformity parameters (DMAA) and lateral fragment shift are more predictive of radiographic outcomes in MIS bunion correction.
• MIS bunion correction demonstrated a low complication rate in this series.