Modified Lapidus Procedure with a Nitinol Staple and Two Screw Construct Technique.

Many fixation options exist for correction of a hallux valgus (HV) deformity with a first tarsometatarsal (TMT) joint arthrodesis with pros and cons to each. Few have looked at utilizing a SMA (shape memory alloy) staple made from nitinol for fixation. This study evaluates the effectiveness of a modified Lapidus technique using a nitinol (shape memory alloy) staple combined with a two-screw construct for first tarsometatarsal (TMT) joint arthrodesis in correcting hallux valgus (HV) deformity.

An interpretable deep learning model for hallux valgus prediction.

Background: This work developed an interpretable deep learning model to automatically annotate landmarks and calculate the hallux valgus angle (HVA) and the intermetatarsal angle (IMA), reducing the time and error of manual calculations by medical experts and improving the efficiency and accuracy of hallux valgus (HV) diagnosis.

Methods: A total of 2,000 foot X-ray images were manually labeled with 12 landmarks by two surgical specialists as training data for the deep learning model. The important parts of the foot X-ray images centered on the proximal phalanx of the bunion (PH1), the first metatarsal (MT1), and the second metatarsal (MT2) were segmented using the proposed AG-UNet in the study.

Percutaneous Surgery for Tailor's Bunion: A Comparative Study.

 To analyze and compare the clinical and radiographic outcomes of bunionette correction using two percutaneous surgical techniques: the Sponsel technique and the medial wedge osteotomy of the distal metaphysis. The results were evaluated individually and comparatively using the American Orthopaedic Foot and Ankle Society's Lesser Metatarsophalangeal-Interphalangeal Scale (AOFAS), Visual Analog Scale (VAS) for pain assessment, and radiographic measurements of the intermetatarsal angle IV-V (AIM4-5) and metatarsophalangeal angle of the fifth ray (AMF-5).  This was a retrospective study conducted from May 2011 to February 2022.

Radiographic and Clinical Outcomes of First Tarsometatarsal Joint Arthrodesis With a Biplanar Locking Plate System Versus the Modified Lapidus Technique With Crossed-Screw Fixation: A Retrospective Multicenter Comparison.

: Hallux valgus (HV) is recognized as a triplanar deformity. A biplanar locking plate (BLP) system corrects this deformity through first tarsometatarsal joint (TMTJ) arthrodesis, with specialized reduction tools and cutting guides. Yet the optimal surgical technique and fixation construct for first TMTJ arthrodesis remains controversial.

Patient expectations in hallux valgus surgery: A qualitative analysis.

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.

VX-548 in the treatment of acute pain.

Acute pain management requires balancing analgesia with adverse effects risk. The voltage-gated sodium channel NaV1.8 plays an important role in pain physiology, and its inhibition was shown to have analgesic effects.

Controversial Matters of Minimally Invasive Bunion Repair.

New minimally invasive bunion surgery for hallux valgus (HV) has received attention in the last few years. A rapid growth in knowledge and techniques has been seen, with many publications, books, and experienced surgeons worldwide. Several variational advancements have emerged with the most common as a percutaneous subcapital osteotomy first metatarsal with long scaffolding minimally invasive (MI) screw placement.

The Unfamiliar Complications of Minimally Invasive Foot Surgery.

Over the last 5 years, minimally invasive surgery (MIS) has seen a significant surge, propelled by advancements in surgical equipment, implants, methodologies, and comprehensive education. The introduction of specialized hardware and advanced bone-cutting burrs has contributed to a reduction in complications. Evidence from peer-reviewed studies suggests that the outcomes of MIS are often on par with, and at times surpass, those of traditional surgical methods.

New Minimally Invasive Bunion Surgery: The End-All Be-All Bunion Repair?

The revival of "new" minimally invasive bunion surgery (MIBS) is made possible as a laparoscopic-like fluoroscopically guided procedure using new instrumentation, advanced osseous realignment techniques and procedure-specific orthopedic hardware. Bunions of all severities can be treated with MIBS with a functional walking recovery in a small surgical shoe. Realignment occurs through a subcapital osteotomy with metatarsal head shifts that are stabilized by a single or dual metatarsal MIBS screw(s) that span a resultant osseous defect.

A New Paradigm for Failed Bunions with Minimally Invasive Methods.

Hallux valgus recurrence after traditional open bunion surgery is a notable concern. New minimally invasive bunion surgery (MIBS) offers a promising new revision option for those with recurrent hallux valgus. This innovative approach signifies a noteworthy departure from traditional open surgical methods by minimizing tissue damage, allowing immediate weight bearing, and providing improved patient satisfaction outcomes.

The History and Instrumentation of Minimally Invasive Pedal Surgery.

The journey through the history of minimally invasive surgery in foot and ankle procedures reveals a remarkable narrative of innovation and progress. Minimally invasive surgery has been adopted in various foot and ankle procedures including elective and trauma surgery. Most notably, the transformative impact of minimally invasive bunion surgery, spanning 3 generations of techniques, showcases a relentless pursuit of precision and efficiency.

Ropivacaine and magnesium sulfate in sciatic nerve block at the popliteal level: randomized double-blind study.

Background: Following surgical procedures, over 80% of patients experience acute pain, with half of them expressing dissatisfaction with pain relief. The modern approach to surgical treatment and pain management increasingly relies on implementing multimodal analgesia, which includes the use of adjuvants in addition to long-acting local anesthetics (such as ropivacaine). This double-blind randomized study evaluated the analgesic effect of magnesium sulfate added to ropivacaine in the sciatic nerve block at the popliteal level for bunion correction surgery.

From Etiology to Intervention: A Holistic Review of Bunion Pathophysiology and Care.

In this review paper, we present the common etiology, presentation, diagnosis, and management of the following three common bunion formations: dorsal bunion, tailor's bunion, and hallux valgus (HV). Bunions are common pathologies that present to a variety of clinics, so it is important for providers to have a base understanding of these in order to provide the best care to patients. Many of these bunion formations have a variety of causes which allow providers to manage them before surgical intervention is required.

Social conditions impact functional outcome in patients with hand osteoarthritis: the low-income hand osteoarthritis (LIHOA) cohort.

Background: Hand osteoarthritis (HOA) is a highly prevalent disease that may be impacted by social inequalities. Few studies in HOA are from underdeveloped regions. We intend to contribute to fill this gap presenting clinical characteristics of our low-income HOA cohort (LIHOA).

Orthoses Effect on Radiographic Measurements of Hallux Abducto Valgus: A Systematic Review.

Background: Hallux abducto valgus (HAV), commonly referred to as a bunion, is a prevalent foot deformity with multifactorial etiology, including genetic predisposition, biomechanical abnormalities, and footwear choices. HAV is often managed conservatively with orthotic devices aimed at reducing deformity progression and alleviating associated pain. However, the effectiveness of orthotics in altering radiographic measurements of HAV remains debated.

Management of Dorsal Bunion in Nonambulatory Adolescents with Cerebral Palsy: A Retrospective Cohort Study.

Background: A dorsal bunion may occur in nonambulatory adolescents with cerebral palsy (CP) and a Gross Motor Function Classification System (GMFCS) level of IV or V. The deformity can cause pain, skin breakdown, and difficulty wearing shoes and braces. A consensus on the biomechanics and surgical management of dorsal bunions in persons with severe CP has not been established.

Biomechanical comparison of reverse offset-L osteotomy and chevron osteotomy in cadaveric hallux valgus surgery.

Objective: Chevron osteotomy offers near-excellent clinical results and adequate stability at lower shift percentages, among the techniques used to correct hallux valgus deformity. This cadaveric study aimed to compare the Chevron osteotomy with the reverse offset-L osteotomy, which may provide a greater surface area and a more stable geometry to withstand higher cantilever forces at higher shift percentages.

Methods: Metatarsal bones obtained from 20 human cadavers with similar bone quality were divided into two groups: Chevron osteotomy was applied to the 1st group and reverse offset-L osteotomy was applied to the 2nd group.