Hallux Valgus Multiplanar Correction Surgery Through a Minimally Invasive Technique. Our Initial Experience.

Abstract

Category: Bunion; Other Introduction/Purpose: Recently, minimally invasive surgery for hallux valgus correction has regained popularity. The minimally invasive Chevron and Akin (MICA), has been proved to be as satisfactory for patients as conventional open techniques. However, due to its design, it is difficult to correct the coronal plane malalignment, which could lead to the recurrence of the deformity. Instead, a Bösch-type osteotomy allows multiplanar correction, and with an upgrade in its fixation we can create a stable third- generation percutaneous osteotomy. We report our early results using the minimally invasive Bösch and Akin osteotomy (MIBA). Methods: This was a prospective case series of our first 40 patients (41 feet) undergoing MIBA procedure. Outcome measures included the Manchester-Oxford Foot Questionnaire (MOXFQ), the AOFAS Forefoot Score, and the visual analog scale (VAS) for pain assessment. Radiographic measures included the hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA) and the pronation of the metatarsal. All complications and emitted radiation dosage were reported as well. Results: At 12 months MOXFQ and AOFAS improved from 54.8 to 0.66 (p=0) and 39.1 to 99.2 (p=0), respectively. The mean preoperative VAS was 5.8, and improved during the first week to 1.3 (p<0.05). There was also a significant improvement in all radiographic parameters. We had two significant and five minor complications. Conclusion: The MIBA procedure is a safe and effective option to achieve a multiplanar hallux valgus correction.