First metatarsal extracapsular osteotomy to treat moderate hallux valgus deformity: the modified Wilson-SERI techinique
Keywords:
hallux valgus, metatarsal osteotomy, foot surgery, minimally invasiveAbstract
From February 2017 to December 2018, 20 patients had undergone the proposed modified Wilson-SERI osteotomy technique, for moderate hallux valgus. The mean age of patients was 58,25 years (range 19 to 78). The hallux valgus angle (HVA), the intermetatarsal angle between first and second metatarsal bone (IMA) and the distal metatarsal articular angle (D.M.A.A) were measured. The feet were assessed based on the scoring system used by Broughton and Winson and by the American Orthopedic Foot and Ankle Society (AOFAS) hallux-metatarsophalangeal-interphalangeal scale.
All twenty one patients were followed up postoperatively for a minimum of 12 months. The mean HVA angle decreased significantly from 31,1° before surgery (range 22.9°-40°SD 5.0) at 11,2° (range 2.5° to 22.0°SD 5.3) at twelve months follow up. The mean IMA angle decreased significantly from 12,5° (range 8.0°-18.6°SD 3.8) before surgery at 7,4° (range 3.4°-14.0°SD 2.5) at twelve months follow up. The mean DMMA angle decreased significantly from 15.1° (range 5.3° to 20.0°SD 4.4) before surgery at 7,4 °(1.5°- 10.7°SD 2.5) at twelve months follow up. The mean score according to the AOFAS forefoot was increased from 22,1 (range 13-30 SD 5.0) to 88,2 (Range 77-96 SD 5.2) (p<0.0001).
No complications, like dislocations, avascular necrosis of the first metatarsal and deep venous thrombosis, were observed in the post-operative period.
Short term results at twelve months after surgery are quite satisfactory but further studies are necessary, to better comprehend an overall outcome of such approach in the long run.
References
Galois L.
History of surgical treatments for hallux valgus.
Eur J OrthopSurgTraumatol. 2018 Dec;28(8):1633-1639. doi: 10.1007/s00590-018-2235-6.
Bia A, Guerra-Pinto F, Pereira BS, Corte-Real N, Oliva XM.
Percutaneous Osteotomies in Hallux Valgus: A Systematic Review.
J Foot Ankle Surg. 2018 Jan - Feb;57(1):123-130. doi: 10.1053/j.jfas.2017.06.027.
Mitchell CL, Fleming JL, Allen R, Glenney C, Sanford GA (1958)
Osteotomy-bunionectomy for hallux valgus.
J Bone Joint Surg Am40(1):41–60
Austin DW, Leventen EO (1981)
A new osteotomy for hallux valgus: a horizontally directed “V” displacement osteotomy of themetatarsal head for hallux valgus and primus varus. ClinOrthopRelat Res 157:25–30. PMID: 7249456
Roukis TS.
Percutaneous and minimum incision metatarsal osteotomies: a systematic review.
J Foot Ankle Surg. 2009 May-Jun;48(3):380-7. doi: 10.1053/j.jfas.2009.01.007.
Malagelada F, Sahirad C, Dalmau-Pastor M, Vega J, Bhumbra R, Manzanares-Céspedes MC, Laffenêtre O.
Minimally invasive surgery for hallux valgus: a systematic review of current surgical techniques. IntOrthop. 2019 Mar;43(3):625-637. doi: 10.1007/s00264-018-4138-x.
Maffulli N, Longo UG, Marinozzi A, Denaro V.
Hallux valgus: effectiveness and safety of minimally invasive surgery. A systematic review.
Br Med Bull. 2011;97:149-67. doi: 10.1093/bmb/ldq027.
Wilson JN.
Oblique displacement osteotomy for hallux valgus.
J Bone Joint Surg Br. 1963;45B:552–6.PMID: 14058333
Giannini S, Faldini C, Nanni M, Di Martino A, Luciani D, VanniniF.
A minimally invasive technique for surgical treatment of hallux valgus: simple, effective, rapid, inexpensive (SERI).
IntOrthop. 2013 Sep;37(9):1805-13. doi: 10.1007/s00264-013-1980-8.
Ceccarelli F, Carolla A, Schiavi P, CalderazziF.
Modified SERI technique in the treatment of hallux valgus combined with arthritis.
JOrthopSurg (Hong Kong). 2018 May-Aug;26(3). doi: 10.1177/2309499018802489.
Almalki T, Alatassi R, Alajlan A, Alghamdi K, AbdulaalA.
Assessment of the efficacy of SERI osteotomy for hallux valgus correction.
JOrthopSurg Res. 2019 Jan 24;14(1):28. doi: 10.1186/s13018-019-1067-3.
Giannini S, Cavallo M, Faldini C, Luciani D, Vannini F.
The SERI distal metatarsal osteotomy and Scarf osteotomy provide similar correction of hallux valgus.
ClinOrthopRelat Res. 2013 Jul;471(7):2305-11. doi: 10.1007/s11999-013-2912-z
Faldini C, Nanni M, Traina F, Fabbri D, Borghi R, Giannini S.
Surgical treatment of hallux valgus associated with flexible flatfoot during growing age.
IntOrthop. 2016 Apr;40(4):737-43. doi: 10.1007/s00264-015-3019-9.
Coughlin MJ, Jones CP.
Hallux valgus: demographics,etiology, and radiographic assessment.
Foot Ankle Int.2007;28(7):759-777.DOI: 10.3113/FAI.2007.0759
Bali N, Fenton P, Prem H.
Disorders of the first ray. Orthop Trauma 28:1–12, 2014.
Availabe at https://pdfs.semanticscholar.org/8d75/250dcd72fa2479bbbf219217f4d752f1fe30.pdf (last access 2020/02/03)
Coughlin MJ, Saltzman CL, Nunley JA 2nd.
Angular measurements in the evaluation of hallux valgus deformities: a report of the ad hoc committee of the American Orthopaedic Foot & Ankle Society on angular measurements.
Foot Ankle Int. 2002 Jan;23(1):68-74.DOI: 10.1177/107110070202300114
Winson IG, Rawlinson J, Broughton NS.
Treatment of metatarsalgia by sliding distal metatarsal osteotomy.
Foot Ankle. 1988 Aug;9(1):2-6.DOI: 10.1177/107110078800900102.
Van Groningen B, van der Steen MC, Reijman M, Bos J, Hendriks JG.
Outcomes in chevron osteotomy for Hallux Valgus in a large cohort.
Foot (Edinb). 2016 Dec;29:18-24. doi: 10.1016/j.foot.2016.09.002.
Brogan K, Lindisfarne E, Akehurst H, Farook U, Shrier W, Palmer S.
Minimally Invasive and Open Distal Chevron Osteotomy for Mild to Moderate Hallux Valgus.Foot Ankle Int. 2016 Nov;37(11):1197-1204.DOI: 10.1177/1071100716656440
Di Giorgio L, Touloupakis G, Simone S, Imparato L, Sodano L, Villani C.
The Endolog system for moderate-to-severe hallux valgus.
J Orthop Surg (Hong Kong). 2013 Apr;21(1):47-50.
Geng X, Shi J, Chen W, Ma X, Wang X, Zhang C, Chen L.
Impact of first metatarsal shortening on forefoot loading pattern: a finite element model study.
BMC Musculoskelet Disord. 2019 Dec 27;20(1):625. doi: 10.1186/s12891-019-2973-6.
Kolundžić R, Mađarević M, Trkulja V, Crnković T, Šmigovec I, Matek D. Croatian rotatory oblique three-dimensional osteotomy (CROTO) - a modified Wilson's osteotomy for adult hallux valgus intended to prevent dorsal displacement of the distal fragment and to reduce shortening of the first metatarsal bone. Med Glas (Zenica). 2017;14(2):250-256. doi:10.17392/903-17
Goldberg A, Singh D. Treatment of shortening following hallux valgus surgery. Foot Ankle Clin. 2014;19(2):309-316. doi:10.1016/j.fcl.2014.02.009
Downloads
Published
Issue
Section
License
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
How to Cite
