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Percutaneous hallux valgus surgery has evolved, with the fourth generation involving a metaphyseal extracapsular transverse osteotomy and akin osteotomy. Correct patient positioning and theater ergonomics are essential to reduce unnecessary fluoroscopy and capture accurate radiographs before osteotomy/wire placement. The position of the head can influence the risk of recurrence. Screw position must be scrutinized to prevent plantarflexing or dorsiflexing of the osteotomy and reduce the risk of postoperative fracture. A lateral release may be required based on intraoperative assessments. Postoperatively, patients follow a protocol that allows accelerated rehabilitation in a controlled fashion.
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http://dx.doi.org/10.1016/j.fcl.2024.11.005 | DOI Listing |
J Pers Med
August 2025
IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136 Bologna, Italy.
The optimal management of hallux sesamoid fracture nonunions remains a subject of ongoing debate, particularly in the context of personalized medicine. This systematic review aimed to synthesize current evidence regarding surgical strategies for this rare but disabling condition. A comprehensive literature search was conducted in accordance with the PRISMA guidelines.
View Article and Find Full Text PDFFoot Ankle Orthop
July 2025
Swiss Leman Institute of Traumatology and Orthopedics ITOLS, Lausanne, Switzerland.
Background: Severe hallux valgus (HV) presents a significant surgical challenge. Traditional methods are being questioned because of their invasiveness, whereas recent minimally invasive techniques raise concerns because of their associated complications. This study evaluates the percutaneous distal metatarsal osteotomy technique, generally found to be effective for mild-to-moderate cases, and tests the hypothesis that it provides effective clinical and radiologic correction for severe deformities.
View Article and Find Full Text PDFJ Bone Joint Surg Am
August 2025
King's Foot and Ankle Unit, King's College London NHS Foundation Trust, London, United Kingdom.
Background: Fourth-generation percutaneous, or minimally invasive, hallux valgus surgery utilizes a transverse osteotomy to achieve deformity correction. There are only a small number of studies reporting the clinical and radiographic outcomes of transverse osteotomies, many of which have methodological limitations such as small sample size, limited radiographic follow-up, or use of non-validated outcome measures. The aim of this study was to provide a methodologically robust investigation of percutaneous transverse osteotomies for hallux valgus deformity.
View Article and Find Full Text PDFFoot Ankle Clin
September 2025
Head Foot and Ankle Section, Foot and Ankle Unit, Hospital Stockach, Am Stadtgarten 10, Stockach 78333, Germany. Electronic address:
The minimally invasive first metatarsophalangeal fusion is a surgical technique designed to address severe arthritis, deformities, or instability in the big toe joint. Unlike traditional open surgery, this approach utilizes small incisions and specialized instruments to remove damaged joint surfaces and fuse the bones, promoting stability and pain relief. The procedure preserves soft tissue, minimizes disruption, and reduces risks of infection and scarring.
View Article and Find Full Text PDFFoot Ankle Clin
September 2025
Department of Foot and Ankle, Orthopaedic and Arthritis Specialist Centre, Level 2/445 Victoria Avenue, Chatswood, Sydney, New South Wales 2067, Australia.
Percutaneous hallux valgus surgery has evolved, with the fourth generation involving a metaphyseal extracapsular transverse osteotomy and akin osteotomy. Correct patient positioning and theater ergonomics are essential to reduce unnecessary fluoroscopy and capture accurate radiographs before osteotomy/wire placement. The position of the head can influence the risk of recurrence.
View Article and Find Full Text PDF