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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2021, Number 2

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Acta Ortop Mex 2021; 35 (2)

Experimental cadaveric study assesing protection and osteotomy guide system (BARU) in hallux valgus surgery using Reverdin-Isham technic

Del CJ, Russi M, Filomeno P, Kenny-Pujadas J, Cabrera-Frola J, Fischer A, Bongiovanni J, Amaya J

Language: Spanish
References: 14
Page: 132-136
PDF size: 262.21 Kb.


ABSTRACT

Introduction: Hallux valgus is a high frequency disorder, affecting the first ray. Operative correction techniques have grown popularity lately. One of them is the Reverdin-Isham technique (first metatarsal medial incomplete osteotomy). Recently, a protection and osteotomy cutting guide has been developed: the BARU system. Objective: To test the usefulness of the BARU system as a protective factor for soft structures adjacent to the surgical site and guidance for osteotomy. Material and methods: Experimental cadaveric study. Six cadaveric feet (two fresh-frozen and four in formaldehyde solution), unapproached. Feet were numbered and intervened with RI technique, three of them with BARU system and three without it. Afterwards, dissection by two dissectors who did not know whether the BARU system had been used or not, establishing a single-blinded model. 13 structures were evaluated in each foot. Data was recovered into Microsoft Office Excel and processed with SPSS. χ2 test (significative if p value < 0.05) and relative risk were calculated. Results: Approach using BARU system was satisfactory, with usual-size operation-ports. BARU system colocation was simple and radiological control showed adequate spatial location. The device contributed as reference for cutting direction and depth. 65 out of the 78 searched structures were found (83.3%). Six injuries were found among the assessed structures: plantar medial nerve (one injury), plantar medial artery (one injury), flexor brevis muscle (three injuries), abductor muscle (one injury). Five of these injuries occurred in non-utilizing BARU system feet. Conclusion: Promising results in terms of protection of nearby structures, cutting guide, and ease of intervention. Avoids X-rays exposure. Not significant statistical calculations, the sample should be enlarged.


REFERENCES

  1. Coughlin MJ, Jones CP. Hallux valgus: Demographics, etiology, and radiographic assessment. Foot Ankle Int. 2007; 28(7): 759-77.

  2. Iselin LD, Klammer G, Espinoza N, Symeonidis PD, Iselin D, Stavrou P. Surgical management of hallux valgus and hallux rigidus: an email survey among Swiss orthopaedic surgeons regarding their current practice Orthopedics and biomechanics. BMC Musculoskelet Disord. 2015; 16(1): 1-7.

  3. Bauer T, Biau D, Lortat-Jacob A, Hardy P. Percutaneous hallux valgus correction using the Reverdin-Isham osteotomy. Orthop Traumatol Surg Res [Internet]. 2010; 96(4): 407-16. Available from: http://dx.doi.org/10.1016/j.otsr.2010.01.007

  4. Maffulli N, Longo UG, Marinozzi A, Denaro V. Hallux valgus: effectiveness and safety of minimally invasive surgery. A systematic review. Br Med Bull. 2011; 97(1): 149-67.

  5. Radwan YA, Mansour AMR. Percutaneous distal metatarsal osteotomy versus distal chevron osteotomy for correction of mild-to-moderate hallux valgus deformity. Arch Orthop Trauma Surg. 2012; 132(11): 1539-46.

  6. Trnka HJ, Krenn S, Schuh R. Minimally invasive hallux valgus surgery: a critical review of the evidence. Int Orthop. 2013; 37(9): 1731-5.

  7. Bauer T, de Lavigne C, Biau D, De Prado M, Isham S, Laffenétre O. Percutaneous hallux valgus surgery: a prospective multicenter study of 189 cases. Orthop Clin North Am. 2009; 40(4): 505-14.

  8. Isham SA, Núñez OE. The Reverdin-Isham procedure for the correction of hallux valgus. In: Maffulli N, Easley M (ed.) Minimally invasive surgery of the foot and ankle. London Springer-Verlag. 2011, 97-108.

  9. Dhukaram V, Chapman AP, Upadhyay PK. Minimally invasive forefoot surgery: a cadaveric study. Foot Ankle Int. 2012; 33(12): 1139-44.

  10. Yañez AJM, del Vecchio JJ, Codesido M, Raimondi N. Minimally invasive Akin osteotomy and lateral release: Anatomical structures at risk: a cadaveric study. Foot (Edinb). 2016; 27: 32-5.

  11. Kaipel M, Reissig L, Albrecht L, Quadlbauer S, Klikovics J, Weninger WJ. Risk of damaging anatomical structures during minimally invasive hallux valgus correction (Bosch technique): an anatomical study. Foot Ankle Int. 2018; 39(11): 1355-9.

  12. Malagelada F, Dalmau-Pastor M, Fargues B, Manzanares-Céspedes MC, Peña F, Vega J. Increasing the safety of minimally invasive hallux surgery: an anatomical study introducing the clock method. Foot Ankle Surg [Internet]. 2018; 24(1): 40-4. Available from: https://doi.org/10.1016/j.fas.2016.11.004

  13. Lim Y, Byun HJ, Park CS, Lee JH, Park JH, Lee JH, et al. Primary cutaneous carcinosarcoma developing after chronic C-arm radiation exposure. JAAD Case Reports [Internet]. 2018; 4(2): 126-8. Available from: https://doi.org/10.1016/j.jdcr.2017.07.024

  14. Malagelada F, Sahirad C, Dalmau-Pastor M, Vega J, Bhumbra R, Manzanares-Céspedes MC, et al. Minimally invasive surgery for hallux valgus: a systematic review of current surgical techniques. Int Orthop. 2019; 43(3): 625-37.



EVIDENCE LEVEL

IV




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