Analysis of the therapeutic effect of minimally invasive extra-articular osteotomy with ultrasonic osteotome in the treatment of moderate and severe hallux valgus
YUAN Han
CHEN Guoliang
XU Mingliang
SHI Rongjian
WEI Di
Abstract：Objective To investigate the clinical effect of minimally invasive extracapsular osteotomy with ultrasonic bone knife in the treatment of moderate and severe hallux valgus.Methods A retrospective analysis was performed on 19 patients(23 feet)with moderate or severe bunions admitted to the Foot and Ankle Surgery Department of Xuzhou Renyi Hospital from January 2022 to January 2024.All of them were corrected by minimally invasive ultrasonic bone knife exocyst osteotomy.Before surgery and at the last follow-up,the anterior-lateral film of foot weight was performed.HVA(hallus valgus Angle),IMA(intermetatarsal Angle),DASA(distal articular set angle),PASA(DMAA)[proximal articular set angle(distal metatarsal articular angle)]and the length of first metatarsal bone were measured and compared.First metatarsophalangeal joint motion,American Orthopedic Foot and Ankle Society(AOFAS)forefoot function score and visual pain analog scale(VAS)were recorded and compared before and at the postoperative 6 months.Results All patients were followed up for 10 to 14 months and the healing time of metatarsal bone was(3.0±1.2)months.The deformity of hallux valgus was corrected after operation,and no complications such as hallux varus,nonunion of osteotomy and skin necrosis occurred.At the postoperative 6 months,HVA,IMA,DASA,PASA(DMAA),AOFAS and VAS were statistically significant compared with those before surgery(P＜0.05).There was no significant difference between the first metatarsophalangeal joint motion and the length of the first metatarsal bone before and at the postoperative 6 months(P＞0.05).In 4 patients with severe bunion valgus combined with Akin(medial wedge osteotomy of proximal pha-langes),1 patient had postoperative numbness and 1 patient had postoperative metastatic metatarsal pain.Conclusion The treatment of moderate and severe bunion valgus with minimally invasive ultrasonic bone knife extracapsulary osteotomy has the advantages of less trau-ma,quick recovery,good appearance and obvious curative effect.
Keywords：Ultrasonic bone knifeHallux valgusMinimally invasiveCapsula articularisHeavyNeck of metatarsal bone
Publication Date：2025-03-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 167-171 )