NDLI: Distal osteotomy of the first metatarsal bone for the correction of hallux valgus: comparison of the sagittal stability of two percutaneous techniques

Content Provider	Springer Nature : BioMed Central
Author	Navarro-Cano, Ester Guevara-Noriega, Kerbi Alejandro Carrera, Anna Tubbs, R. Shane Sanjuan-Castillo, Maria Angeles Iwanaga, Joe Vizcaya, Sara Reina, Francisco
Abstract	Background Distal first metatarsal osteotomy is used to correct mild or moderate hallux valgus (HV). We designed a cadaveric study to compare the resistance to axial load between two percutaneous distal first metatarsal osteotomies: Bösch osteotomy and percutaneous chevron. The first aim of this study was to develop a systematic technique for measuring the sagittal displacement on lateral foot X-rays. Our second objective was to measure the resistance to axial load for both of these osteotomies. Methods Ten pairs of freshly frozen cadaveric feet were randomly assigned to one of the two techniques investigated. Pre- and post-operative lateral X-rays were obtained. After surgery, the feet were placed under progressive axial loads up to 60 kg. Metaphyseo-diaphyseal angle (MDA) and the distance between bone fragments were measured, and the differences between the two techniques were statistically assessed. Results The MDA decreased in both surgical techniques. The mean plantar tilt was −6.90 degrees (SD = 10.251) for chevron osteotomy and −5.34 degrees (SD = 16.621) for Bösch osteotomy. There was no significant difference between the techniques (p = 0.41). Regarding the distance between the bone fragments, the Bösch osteotomy produced more plantar displacement than the chevron osteotomy, which was statistically significant for the 10 and 20 kg loads (p = 0.031 and 0.04, respectively). At loads ≥ 30 kg, the bone fragment distance did not differ significantly between the techniques (p = 0.114). Conclusions Although the chevron technique confers higher stability regarding fragment displacement during axial loading, both techniques increase the plantar angulation of the metatarsal head. Level of evidence Cadaveric study. Level V.
Related Links	https://josr-online.biomedcentral.com/counter/pdf/10.1186/s13018-023-03702-y.pdf
Ending Page	8
Page Count	8
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s13018-023-03702-y
Journal	Journal of Orthopaedic Surgery and Research
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2023-03-18
Access Restriction	Open
Subject Keyword	Orthopedics Surgical Orthopedics Foot Hallux valgus Minimally invasive Percutaneous surgery
Content Type	Text
Resource Type	Article
Subject	Surgery Orthopedics and Sports Medicine
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3/2023

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