Radiographic Forefoot Width Following Minimally Invasive Chevron Akin Bunionectomy
Background: Hallux valgus (HV) is a common cause of pain and deformity of the forefoot. Minimally invasive chevron Akin (MICA) bunionectomy is a method for HV correction associated with less pain and swelling, with early return to weightbearing in a regular shoe. The purpose of this study was to det...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-01-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/24730114221148191 |
| _version_ | 1797938238420156416 |
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| author | Derek M. Klavas MD Dov L. Rosemberg MD Glaucia Bordignon MD Johnny Lin MD Simon Lee MD Daniel D. Bohl MD, MPH |
| author_facet | Derek M. Klavas MD Dov L. Rosemberg MD Glaucia Bordignon MD Johnny Lin MD Simon Lee MD Daniel D. Bohl MD, MPH |
| author_sort | Derek M. Klavas MD |
| collection | DOAJ |
| description | Background: Hallux valgus (HV) is a common cause of pain and deformity of the forefoot. Minimally invasive chevron Akin (MICA) bunionectomy is a method for HV correction associated with less pain and swelling, with early return to weightbearing in a regular shoe. The purpose of this study was to determine how the MICA procedure affects forefoot width. Methods: Twenty-eight patients (26 female, 2 male; 9 left, 19 right) at a single institution who underwent primary MICA for HV correction by 3 treating surgeons were retrospectively reviewed. Pre- and postoperative hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), bony forefoot width, and soft tissue forefoot width were measured by 2 independent observers. Radiographic measurements were calibrated using fifth metatarsal length. Wilcoxon signed rank test compared changes in HVA, IMA, DMAA, and forefoot widths. Pearson correlation coefficient evaluated association between HVA, IMA, DMAA, and changes in forefoot width. Results: At mean follow-up of 5.4 (range 3-13.7) months, bony forefoot width decreased significantly by 3.7 mm (4%, P < .001) and soft tissue forefoot width decreased by 2.5 mm (2%, P < .01). Decrease in HVA was moderately correlated with change in bony forefoot width ( r = .38, P < .05) and change in soft tissue forefoot width ( r = .45, P < .05). Decrease in IMA was moderately correlated with change in bony forefoot width ( r = .45, P < .05) and change in soft tissue forefoot width ( r = .44, P < .05). Conclusion: The MICA procedure resulted in modest, yet significant, decrease in both bony and soft tissue forefoot width. Decrease in HVA and IMA demonstrated moderate correlation with changes in forefoot width. Patients can be counseled on these changes leading up to, and after, MICA bunionectomy surgery. Level of Evidence: Level III, retrospective comparative series. |
| first_indexed | 2024-04-10T18:57:38Z |
| format | Article |
| id | doaj.art-2acdec38a87045d282d46c7a7a71dbd4 |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-04-10T18:57:38Z |
| publishDate | 2023-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-2acdec38a87045d282d46c7a7a71dbd42023-01-31T16:34:25ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142023-01-01810.1177/24730114221148191Radiographic Forefoot Width Following Minimally Invasive Chevron Akin BunionectomyDerek M. Klavas MD0Dov L. Rosemberg MD1Glaucia Bordignon MD2Johnny Lin MD3Simon Lee MD4Daniel D. Bohl MD, MPH5Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USALab. Prof. Manlio Mario Marco Napoli, Departamento de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BrazilHospital Municipal Universitário de Taubaté, Taubaté, SP, BrazilDepartment of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USADepartment of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USADepartment of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USABackground: Hallux valgus (HV) is a common cause of pain and deformity of the forefoot. Minimally invasive chevron Akin (MICA) bunionectomy is a method for HV correction associated with less pain and swelling, with early return to weightbearing in a regular shoe. The purpose of this study was to determine how the MICA procedure affects forefoot width. Methods: Twenty-eight patients (26 female, 2 male; 9 left, 19 right) at a single institution who underwent primary MICA for HV correction by 3 treating surgeons were retrospectively reviewed. Pre- and postoperative hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), bony forefoot width, and soft tissue forefoot width were measured by 2 independent observers. Radiographic measurements were calibrated using fifth metatarsal length. Wilcoxon signed rank test compared changes in HVA, IMA, DMAA, and forefoot widths. Pearson correlation coefficient evaluated association between HVA, IMA, DMAA, and changes in forefoot width. Results: At mean follow-up of 5.4 (range 3-13.7) months, bony forefoot width decreased significantly by 3.7 mm (4%, P < .001) and soft tissue forefoot width decreased by 2.5 mm (2%, P < .01). Decrease in HVA was moderately correlated with change in bony forefoot width ( r = .38, P < .05) and change in soft tissue forefoot width ( r = .45, P < .05). Decrease in IMA was moderately correlated with change in bony forefoot width ( r = .45, P < .05) and change in soft tissue forefoot width ( r = .44, P < .05). Conclusion: The MICA procedure resulted in modest, yet significant, decrease in both bony and soft tissue forefoot width. Decrease in HVA and IMA demonstrated moderate correlation with changes in forefoot width. Patients can be counseled on these changes leading up to, and after, MICA bunionectomy surgery. Level of Evidence: Level III, retrospective comparative series.https://doi.org/10.1177/24730114221148191 |
| spellingShingle | Derek M. Klavas MD Dov L. Rosemberg MD Glaucia Bordignon MD Johnny Lin MD Simon Lee MD Daniel D. Bohl MD, MPH Radiographic Forefoot Width Following Minimally Invasive Chevron Akin Bunionectomy Foot & Ankle Orthopaedics |
| title | Radiographic Forefoot Width Following Minimally Invasive Chevron Akin Bunionectomy |
| title_full | Radiographic Forefoot Width Following Minimally Invasive Chevron Akin Bunionectomy |
| title_fullStr | Radiographic Forefoot Width Following Minimally Invasive Chevron Akin Bunionectomy |
| title_full_unstemmed | Radiographic Forefoot Width Following Minimally Invasive Chevron Akin Bunionectomy |
| title_short | Radiographic Forefoot Width Following Minimally Invasive Chevron Akin Bunionectomy |
| title_sort | radiographic forefoot width following minimally invasive chevron akin bunionectomy |
| url | https://doi.org/10.1177/24730114221148191 |
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