Minimally invasive osteotomy of hallux valgus
10.3760/cma.j.cn121113-20241107-00632
- VernacularTitle:微创截骨矫形术治疗 外翻
- Author:
Xu WANG
1
;
Zhaolin TENG
1
;
Xiang GENG
1
Author Information
1. 复旦大学附属华山医院骨科，上海 200040
- Publication Type:Journal Article
- Keywords:
Hallux valgus;
Osteotomy;
Minimally invasive surgical procedures
- From:
Chinese Journal of Orthopaedics
2025;45(3):192-196
- CountryChina
- Language:Chinese
-
Abstract:
Hallux valgus is one of the common foot deformities. Osteotomy can effectively correct hallux valgus and relieve pain. In recent years, minimally invasive osteotomy for hallux valgus has attracted the attention of doctors and patients due to its perioperative advantages (small incision and fast recovery) and effectiveness. Compared with the first and second generation minimally invasive osteotomy techniques for hallux valgus, the third generation of minimally invasive techniques has the advantages of easy osteotomy, strong correction ability, and stable internal fixation, so it has been rapidly promoted at home and abroad. Although it has been reported that the third generation of minimally invasive techniques has satisfactory therapeutic effects, complications such as nerve damage and metastatic metatarsalgia are reported as well. Therefore, there are many key points and skills in the surgery that deserve attention. A high-torque power system, portable intraoperative fluoroscopy equipment, and appropriate reduction and internal fixation instruments are all prerequisites for the technique. The minimally invasive osteotomy is V-shaped or transverse (some surgeons define the transverse osteotomy as the fourth-generation technique). The direction of osteotomy is recommended to be perpendicular to the second metatarsal. Three-dimensional orthopedics should be paid attention to when extrapolating metatarsal heads such as crowbars, "in-out-in" method can be used to avoid the dorsomedial cutaneous nerve when internal fixation and nail placement, the continuity of the contralateral cortex should be preserved as much as possible when Akin osteotomy is used, the release of the lateral adductor muscle and the tightening of the medial joint capsule are helpful to further achieve soft tissue balance, and good postoperative bandaging and analgesia are also important links to ensure the treatment effect. In summary, it requires a certain learning curve and operational experience to master the minimally invasive technique. Performing surgery according to indications, doing a good job of preoperative evaluation and perioperative management are conducive to obtaining a good prognosis.
