Establishment of Minimum Clinically Important Difference and Patient Acceptable Symptom State Thresholds for Foot and Ankle Ability Measure and Visual Analog Scale Scores After Hallux Valgus Surgery - Summary by Liv Harley Street Hospital
Bunion Surgery London

Establishment of Minimum Clinically Important Difference and Patient Acceptable Symptom State Thresholds for Foot and Ankle Ability Measure and Visual Analog Scale Scores After Hallux Valgus Surgery – Summary by Liv Harley Street Hospital

CONCLUSION: This study identified useful values for the MCID and PASS thresholds of FAAM-ADL, SANE, and VAS scores at 1-year follow-up for patients undergoing hallux valgus surgery. Overall, despite not meeting the MCID thresholds, patients undergoing hallux valgus surgery were still likely to be satisfied with their surgery.

Modified Medial Capsulorrhaphy Using Figure-of-Eight Suture in Hallux Valgus Correction Surgery - Summary by Liv Harley Street Hospital
Bunion Surgery London

Modified Medial Capsulorrhaphy Using Figure-of-Eight Suture in Hallux Valgus Correction Surgery – Summary by Liv Harley Street Hospital

Objective: Medial capsulorrhaphy is an important step in hallux valgus correction surgery; however, studies on this technique are limited. This study aimed to evaluate the viability and efficacy of modified medial capsulorrhaphy using figure-of-eight sutures for hallux valgus compared to the conventional technique. Methods: Retrospective analysis was performed on patients with hallux valgus, comparing a group receiving standard longitudinal capsulorrhaphy (Group 1) and a group that underwent…

Long Hallucal Tendon Force Vectors and First Metatarsophalangeal Deformity After Hallux Valgus Surgery - Summary by Liv Harley Street Hospital
Bunion Surgery London

Long Hallucal Tendon Force Vectors and First Metatarsophalangeal Deformity After Hallux Valgus Surgery – Summary by Liv Harley Street Hospital

CONCLUSION: In our study, DFA was associated with hallux valgus recurrence when it exceeded 9.5 degrees and hallux varus when it was less than 5.5 degrees. Moreover, in the hallux valgus surgery we performed, a DFA from 5.5 to 9.5 degrees appeared to be a “safe zone” for preventing early deformity after surgery.

Impact of surgery simulation using a 3-dimensional printed model on outcomes of hallux valgus surgery with distal chevron osteotomy: A randomized controlled trial - Summary by Liv Harley Street Hospital
Bunion Surgery London

Impact of surgery simulation using a 3-dimensional printed model on outcomes of hallux valgus surgery with distal chevron osteotomy: A randomized controlled trial – Summary by Liv Harley Street Hospital

CONCLUSION: Simulating surgery on a 3D model and using it as a guide significantly enhances surgical outcomes. Benefits include reduced operation time, tourniquet duration, decreased fluoroscopy usage, and improved first-ray alignment. The 3DS method also ensures better lateralization of the first metatarsal head and correction of the IM. Although 3D model-assisted HV chevron osteotomy surgery provides ideal deformity correction, it does not significantly affect postoperative functional…

Correction of Distal Metatarsal Articular Angle in Hallux Valgus Surgery Utilizing a Minimally Invasive Extra-Articular Metaphyseal Distal Transverse Osteotomy - Summary by Liv Harley Street Hospital
Bunion Surgery London

Correction of Distal Metatarsal Articular Angle in Hallux Valgus Surgery Utilizing a Minimally Invasive Extra-Articular Metaphyseal Distal Transverse Osteotomy – Summary by Liv Harley Street Hospital

Hallux valgus deformity frequently presents with an increased distal metatarsal articular angle (DMAA) which may require additional correction. Minimally invasive hallux valgus surgery is often used in patients with increased DMAA. We hypothesized that the triplanar correction with the minimally invasive extra-articular metaphyseal distal transverse osteotomy (META) would improve the DMAA, in addition to the hallux valgus angle (HVA), intermetatarsal angle (IMA), and patient-reported outcomes. A…

The Filament Union Sign: Prevalence and Clinical Outcomes of Incomplete Bone Remodeling Following Percutaneous Hallux Valgus Surgery - Summary by Liv Harley Street Hospital
Bunion Surgery London

The Filament Union Sign: Prevalence and Clinical Outcomes of Incomplete Bone Remodeling Following Percutaneous Hallux Valgus Surgery – Summary by Liv Harley Street Hospital

CONCLUSION: The filament union sign is an uncommon radiographic finding following percutaneous hallux valgus surgery, occurring in 3% of cases. Although its presence was associated with statistically significant decreased functional outcomes, this difference did not meet the threshold for clinical significance and was also not associated with an increased rate of mechanical failure/fracture or revision surgery rate. Further research is needed to fully understand the mechanical and biological…

Triple osteotomy of first ray for severe hallux valgus surgery: Long-term follow-up - Summary by Liv Harley Street Hospital
Bunion Surgery London

Triple osteotomy of first ray for severe hallux valgus surgery: Long-term follow-up – Summary by Liv Harley Street Hospital

This study aimed to present a retrospective case series of the long-term results of severe hallux valgus treated with triple osteotomy of the first ray. Patients with severe hallux valgus treated with a basal medial opening wedge, distal chevron, and Akin osteotomy from 2008 to 2012 were identified from the electronic medical records. Radiological outcomes such as pre- and postoperative hallux valgus angle, intermetatarsal angle, and distal metatarsal articular angle) were collected. Patients…

Treating Hallux Valgus Associated Metatarsus Adductus by Minimally Invasive Surgery: A Simple Solution for a Difficult Problem - Summary by Liv Harley Street Hospital
Bunion Surgery London

Treating Hallux Valgus Associated Metatarsus Adductus by Minimally Invasive Surgery: A Simple Solution for a Difficult Problem – Summary by Liv Harley Street Hospital

This study aims to assess a novel minimally invasive surgical technique that addresses hallux valgus accompanied by metatarsus adductus. We retrospectively analysed the results of 20 patients (21 feet) that underwent a newly developed percutaneous osteotomy procedure of the lesser metatarsal bones in order to correct hallux valgus deformities accompanied by metatarsus adductus. We used x-ray studies in order to evaluate changes in the hallux valgus angle, the first intermetatarsal angle, and the…

Biomechanical Consequences of Proximal Screw Placement in Minimally Invasive Surgery for Hallux Valgus Correction - Summary by Liv Harley Street Hospital
Bunion Surgery London

Biomechanical Consequences of Proximal Screw Placement in Minimally Invasive Surgery for Hallux Valgus Correction – Summary by Liv Harley Street Hospital

Hallux valgus is one of the most common surgically corrected forefoot deformities. Studies evaluating clinical outcomes of minimally invasive chevron and akin (MICA) procedure have shown shorter operation time, faster recovery, and smaller scars compared to the open approach. Previous biomechanical cadaveric studies have largely focused on the open approach with minimal on MICA. To our knowledge, no studies have compared different proximal screw placements in MICA which can either be three-point…

Patient expectations in hallux valgus surgery: A qualitative analysis - Summary by Liv Harley Street Hospital
Bunion Surgery London

Patient expectations in hallux valgus surgery: A qualitative analysis – Summary by Liv Harley Street Hospital

This study provides an in-depth exploration of patient expectations with hallux valgus surgery using a qualitative approach. Twenty patients awaiting surgery for symptomatic hallux valgus completed a 20-minute semi-structured interview to elicit rich, nuanced information regarding their expectations for bunion surgery. Interviews were transcribed and independently coded by three reviewers. Codes were combined and analyzed by three reviewers to produce over-arching themes that represented…

Improving postoperative analgesia in hallux valgus surgery: oral opioids suppression by addition of a single transdermal fentanyl patch: a prospective evaluation - Summary by Liv Harley Street Hospital
Bunion Surgery London

Improving postoperative analgesia in hallux valgus surgery: oral opioids suppression by addition of a single transdermal fentanyl patch: a prospective evaluation – Summary by Liv Harley Street Hospital

The last decade there is an exponential increase in opioid related deaths. This is proven to be correlated with the rising medical prescription rates of strong opioids. We investigated whether pain after hallux valgus surgery under popliteal nerve block could be adequately controlled without the prescription of oral opioids, with a single transdermal fentanyl patch. In this prospective observational study with 100 patients undergoing corrective first metatarsal osteotomies we prospectively…