Minimally invasive bunionette treatment

clinical and radiographic results

  • Alexander Felipe de Vete Lima Hospital Universitário Ciências Médicas (FCMMG), Belo Horizonte, MG, Brazil
  • Tiago Soares Baumfeld Universidade Federal de Minas Gerais (UFMG), MG, Brazil
  • Bruno Maciel Maciel Hospital São José, Conselheiro Lafaiete, MG, Brazil
  • Daniel Soares Baumfeld Universidade Federal de Minas Gerais (UFMG), MG, Brazil
  • Guillaume Cordier Grecmip MIFAS (Group of Research and Study in Minimally Invasive Surgery of the Foot – Minimally Invasive Foot and Ankle Society), Belo Horizonte, MG, Brazil and Clinique du Sport Bordeaux, Mérignac, France
  • Gustavo Araújo Nunes Grecmip MIFAS (Group of Research and Study in Minimally Invasive Surgery of the Foot – Minimally Invasive Foot and Ankle Society), Belo Horizonte, MG, Brazil and Instituto Orizonti, Belo Horizonte, MG, Brazil
Keywords: Bunion, Tailor’s, Minimally invasive surgical procedures/methods, Metatarsal bones/surgery, Forefoot, Human/surgery, Treatment outcome

Abstract

Objective: To report the clinical and radiographic results of surgical treatment of bunionette deformity with a minimally invasive technique without the use of hardware. Methods: This is a case series of 13 patients (14 feet) with a diagnosis of bunionette surgically treated with a minimally invasive osteotomy of the fifth metatarsal. All patients completed the American Orthopedic Foot and Ankle Society (AOFAS) score and a visual analog scale (VAS) for pain preoperatively and in the last follow-up visit. Radiographic measurements included the fourth-fifth intermetatarsal angle (4-5 IMA) and the fifth metatarsophalangeal (MTP-5) angle. Complications and level of patient satisfaction were also documented. Results: Mean follow-up was 12.3 months. The mean AOFAS score increased from 51.3 to 94.0, and the VAS score decrease from 7.5 to 1.1. The MTP-5 angle decreased from 11.5º to 2.3º, and the 4-5 IMA decreased from 9.8º to 3.6º. These outcomes showed a statistically significant difference (p<0.001). The only complication was hypertrophic callus formation observed in 3 feet (21.4%). There were no cases of infection, neurapraxia, wound dehiscence, nonunion, or deformity recurrence. Ten patients rated their outcome as excellent and 3 as good. Conclusion: Treatment of bunionette with percutaneous osteotomy of the fifth metatarsal without the use of hardware showed good clinical and radiographic results, with a low complication rate and a high level of patient satisfaction. Level of Evidence IV; Therapeutic Studies; Case Series.

Published
30-08-2020
How to Cite
Lima, A. F. de V., Baumfeld, T. S., Maciel, B. M., Baumfeld, D. S., Cordier, G., & Nunes, G. A. (2020). Minimally invasive bunionette treatment: clinical and radiographic results. Journal of the Foot & Ankle, 14(2), 148-152. https://doi.org/10.30795/jfootankle.2020.v14.1160