Clinical application strategy of the fourth generation minimally invasive surgery for hallux valgus
10.3760/cma.j.cn121113-20240902-00487
- VernacularTitle:第四代微创技术治疗 外翻的疗效
- Author:
Yin ZOU
1
;
Li LI
1
;
Hao LU
1
;
Guicheng LI
1
;
Chengbo DU
1
;
Hailin XU
1
Author Information
1. 北京大学人民医院创伤骨科，北京 100044
- Publication Type:Journal Article
- Keywords:
Hallux valgus;
Minimally invasive surgical procedures;
Osteotomy;
Soft tissue release
- From:
Chinese Journal of Orthopaedics
2025;45(3):166-171
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical efficacy of the fourth-generation minimally invasive surgery (MIS) for the treatment of hallux valgus.Methods:A retrospective analysis was conducted on 26 patients (42 feet) who underwent fourth-generation MIS for hallux valgus at Peking University People's Hospital from October 2019 to March 2023. The patients included 5 males (9 feet) and 21 females (33 feet), with an average age of 49.9±15.1 years (range 19-75 years). The hallux valgus deformity was corrected through minimally invasive extra-articular transverse osteotomy of the distal metatarsal combined with Akin osteotomy, fixation with a single fully threaded screw, and lateral soft tissue release after osteotomy. The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured before surgery and at the final follow-up. The American Orthopaedic Foot and Ankle Society (AOFAS) scoring system and the visual analogue scale (VAS) were used to evaluate the treatment efficacy.Results:All 26 patients (42 feet) were followed up for a mean duration of 9.6±5.2 months (range 6-30 months). All 42 feet successfully underwent surgery, with an average operation time of 69.1±16.2 minutes (range 30-105 minutes) and an average blood loss of 10.0±7.4 ml (range 1-30 ml). No serious complications such as major vessel, nerve, or tendon damage occurred during the surgery for any patient. During the follow-up, one foot developed stiffness in the first metatarsophalangeal joint due to a lack of timely functional exercise after surgery. No other complications such as recurrence, delayed union, or nonunion were observed. By the final follow-up, one patient (2 feet) requested removal of the internal fixation. The HVA before surgery and at the final follow-up was 29.5±7.4 and 9.2±4.6, respectively, while the IMA was 11.9±3.8 and 5.0±3.6. The AOFAS score improved from 56.6±10.2 to 91.7±6.8, and the VAS score decreased from 5.2±2.3 to 0.9±1.1, all with significant differences ( P<0.05). Conclusion:The fourth-generation minimally invasive surgery for hallux valgus, characterized by minimally invasive transverse osteotomy, fixation with a single fully threaded screw, lateral soft tissue release after osteotomy, and Akin osteotomy is simple, safe, effective and easy to operate with fewer complications.
