Outcomes and Comparisons of Minimally Invasive Distal Metatarsal and Phalangeal Osteotomies With Traditional Open Osteotomies for Hallux Valgus Deformity.

Background: Ongoing efforts and innovations to improve current bunionectomy procedures have led to a resurgence of minimally invasive surgery.

Methods: A retrospective review of 23 patients who underwent a minimally invasive distal metatarsal and phalangeal osteotomy bunionectomy procedure was undertaken. The procedure was accomplished using stab incisions (less than 5 mm in length) for the introduction of cutting routers and fixation devices to avoid disruption of the soft tissues in and around the first metatarsophalangeal joint, including avoidance of first metatarsophalangeal joint lateral soft tissue release.

Results: The results revealed that the procedure led to an average reduction in first intermetatarsal angle of 63% (14.5° preoperatively versus 5.3° postoperatively) and a reduction in hallux abductus angle of 54% (33.8° preoperatively versus 15.5° postoperatively). Tibial sesamoid position was also recorded and reduced by 63% (an average position of 5 preoperatively versus an average position of 2 postoperatively).

Conclusions: A review of recent literature demonstrated that these results were comparable to open midshaft and base osteotomies.