Minimally Invasive Chevron Akin Osteotomy: Preoperative Planning Using the Radiographic First-Ray Squeeze Test
Background: Recognizing preoperative first-ray hypermobility is important to planning hallux valgus (HV) surgery. A recent study showed the minimally invasive chevron Akin (MICA) osteotomy increased varus displacement of the proximal fragment of the first metatarsal osteotomy. The present study aims...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2024-03-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/24730114241239331 |
| _version_ | 1827294494293229568 |
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| author | Gustavo Araujo Nunes PhD(c) Gabriel Ferraz Ferreira PhD Miguel Viana Pereira Filho MD Kepler Alencar Mendes de Carvalho MD Thomas Lorchan Lewis MBChB (Hons) BSc. (Hons) FRCS (Tr&Orth) MFSTEd Jorge Castellini MD Robbie Ray MbChB, ChM (T&O), FRCSed (T&O), FEBOT Joel Vernois MD |
| author_facet | Gustavo Araujo Nunes PhD(c) Gabriel Ferraz Ferreira PhD Miguel Viana Pereira Filho MD Kepler Alencar Mendes de Carvalho MD Thomas Lorchan Lewis MBChB (Hons) BSc. (Hons) FRCS (Tr&Orth) MFSTEd Jorge Castellini MD Robbie Ray MbChB, ChM (T&O), FRCSed (T&O), FEBOT Joel Vernois MD |
| author_sort | Gustavo Araujo Nunes PhD(c) |
| collection | DOAJ |
| description | Background: Recognizing preoperative first-ray hypermobility is important to planning hallux valgus (HV) surgery. A recent study showed the minimally invasive chevron Akin (MICA) osteotomy increased varus displacement of the proximal fragment of the first metatarsal osteotomy. The present study aims to evaluate the ability of the radiographic first-ray squeeze test to predict the varus displacement of the proximal fragment of the first metatarsal osteotomy when performing the MICA procedure. Methods: A prospective case series of patients with moderate to severe HV who underwent MICA was performed. The HV deformity correction was analyzed by comparing the preoperative and 12-week postoperative hallux valgus angle (HVA) and the intermetatarsal angle between the first and second rays (1-2 IMA). The ability of the radiographic first-ray squeeze test to predict the varus displacement of the first metatarsal was done by comparing the preoperative 1-2 IMA measured in the AP radiographic first-ray squeeze test (IMA-ST) with the intermetatarsal angle between the second metatarsal and the axis of the first metatarsal osteotomy proximal fragment (IAPF) taken 12 weeks postoperatively. Results: Between July 2022 and May 2023, a total of 39 feet in 28 patients underwent MICA. The mean IMA improved from 13.8 (SD = 2.2) to 3.8 degrees (SD = 1.5) ( P < .001), and the mean HVA improved from 27.8 (SD = 6.1) to 4.9 degrees (SD = 2.5) ( P < .001). A linear regression analysis revealed that IMA-ST is highly associated with the 12 week assessed IAPF ( P < .001). Conclusion: The preoperative radiographic first-ray squeeze test appears to predict with high fidelity the varus displacement of the proximal fragment of the first metatarsal that can occur after the MICA procedure. Level of Evidence : Level III, prospective cohort study. |
| first_indexed | 2024-04-24T14:03:47Z |
| format | Article |
| id | doaj.art-e46810cab8d94662b9424f9d63298c27 |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-04-24T14:03:47Z |
| publishDate | 2024-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-e46810cab8d94662b9424f9d63298c272024-04-03T12:03:23ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142024-03-01910.1177/24730114241239331Minimally Invasive Chevron Akin Osteotomy: Preoperative Planning Using the Radiographic First-Ray Squeeze TestGustavo Araujo Nunes PhD(c)0Gabriel Ferraz Ferreira PhD1Miguel Viana Pereira Filho MD2Kepler Alencar Mendes de Carvalho MD3Thomas Lorchan Lewis MBChB (Hons) BSc. (Hons) FRCS (Tr&Orth) MFSTEd4Jorge Castellini MD5Robbie Ray MbChB, ChM (T&O), FRCSed (T&O), FEBOT6Joel Vernois MD7MIFAS by GRECMIP, Bordeaux-Merignac, FranceFoot and Ankle Surgery Group, Orthopedic and Traumatology Unit Prevent Senior, São Paulo, BrazilFoot and Ankle Surgery Group, Orthopedic and Traumatology Unit Prevent Senior, São Paulo, BrazilDepartment of Orthopedic Surgery, Duke University, Durham, NC, USAKing’s Foot and Ankle Unit, King’s College Hospital National Health Service Foundation Trust, London, United KingdomPrivate practice, Ciudad Autónoma de Buenos Aires, ArgentinaKing’s Foot and Ankle Unit, King’s College Hospital National Health Service Foundation Trust, London, United KingdomInstitut de Chirurgie du Pied (ICP), Clinique Blomet, Paris, FranceBackground: Recognizing preoperative first-ray hypermobility is important to planning hallux valgus (HV) surgery. A recent study showed the minimally invasive chevron Akin (MICA) osteotomy increased varus displacement of the proximal fragment of the first metatarsal osteotomy. The present study aims to evaluate the ability of the radiographic first-ray squeeze test to predict the varus displacement of the proximal fragment of the first metatarsal osteotomy when performing the MICA procedure. Methods: A prospective case series of patients with moderate to severe HV who underwent MICA was performed. The HV deformity correction was analyzed by comparing the preoperative and 12-week postoperative hallux valgus angle (HVA) and the intermetatarsal angle between the first and second rays (1-2 IMA). The ability of the radiographic first-ray squeeze test to predict the varus displacement of the first metatarsal was done by comparing the preoperative 1-2 IMA measured in the AP radiographic first-ray squeeze test (IMA-ST) with the intermetatarsal angle between the second metatarsal and the axis of the first metatarsal osteotomy proximal fragment (IAPF) taken 12 weeks postoperatively. Results: Between July 2022 and May 2023, a total of 39 feet in 28 patients underwent MICA. The mean IMA improved from 13.8 (SD = 2.2) to 3.8 degrees (SD = 1.5) ( P < .001), and the mean HVA improved from 27.8 (SD = 6.1) to 4.9 degrees (SD = 2.5) ( P < .001). A linear regression analysis revealed that IMA-ST is highly associated with the 12 week assessed IAPF ( P < .001). Conclusion: The preoperative radiographic first-ray squeeze test appears to predict with high fidelity the varus displacement of the proximal fragment of the first metatarsal that can occur after the MICA procedure. Level of Evidence : Level III, prospective cohort study.https://doi.org/10.1177/24730114241239331 |
| spellingShingle | Gustavo Araujo Nunes PhD(c) Gabriel Ferraz Ferreira PhD Miguel Viana Pereira Filho MD Kepler Alencar Mendes de Carvalho MD Thomas Lorchan Lewis MBChB (Hons) BSc. (Hons) FRCS (Tr&Orth) MFSTEd Jorge Castellini MD Robbie Ray MbChB, ChM (T&O), FRCSed (T&O), FEBOT Joel Vernois MD Minimally Invasive Chevron Akin Osteotomy: Preoperative Planning Using the Radiographic First-Ray Squeeze Test Foot & Ankle Orthopaedics |
| title | Minimally Invasive Chevron Akin Osteotomy: Preoperative Planning Using the Radiographic First-Ray Squeeze Test |
| title_full | Minimally Invasive Chevron Akin Osteotomy: Preoperative Planning Using the Radiographic First-Ray Squeeze Test |
| title_fullStr | Minimally Invasive Chevron Akin Osteotomy: Preoperative Planning Using the Radiographic First-Ray Squeeze Test |
| title_full_unstemmed | Minimally Invasive Chevron Akin Osteotomy: Preoperative Planning Using the Radiographic First-Ray Squeeze Test |
| title_short | Minimally Invasive Chevron Akin Osteotomy: Preoperative Planning Using the Radiographic First-Ray Squeeze Test |
| title_sort | minimally invasive chevron akin osteotomy preoperative planning using the radiographic first ray squeeze test |
| url | https://doi.org/10.1177/24730114241239331 |
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