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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Role of lateral soft tissues release in percutaneous hallux valgus correction: A medium term retrospective study
Fabio Zanchini, Ottorino Catani, Fabrizio Sergio, Alessia Boemio, Angelo Sieczak, Davide Piscopo, Salvatore Risitano, Gabriele Colò, Federico Fusini
Fabio Zanchini, Division of Orthopaedics and Traumatology, Multidisciplinary Department of Medical-Surgical and Dental Specialties, Clinical Orthopeadics, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
Ottorino Catani, Department of Foot Surgery, Casa di cura Santa Maria, Santa Maria Capua Vetere 81055, Italy
Fabrizio Sergio, Department of Foot an Ankle Surgery, Casa di cura Santa Maria, Santa Maria Capua Vetere 81055, Italy
Alessia Boemio, Multidisciplinary Department of Medical-Surgical and Dental Specialties, Clinical Orthopeadics, AOU Luigi Vanvitelli, Napoli 80138, Italy
Angelo Sieczak, Davide Piscopo, Clinical Orthopeadics, University of Campania Luigi Vanvitelli, Naples 80138, Italy
Salvatore Risitano, Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Centre, Città della Salute e della Scienza di Torino, Turin 10126, Italy
Gabriele Colò, Department of Orthopaedics and Traumatology, Regional Center for Joint Arthroplasty, ASO Alessandria, Alessandria 15121, Italy
Federico Fusini, Department of Orthopaedic and Traumatology, Regina Montis Regalis Hospital, Cuneo 12084, Italy
Author contributions: Zanchini F, Catani O, and Sergio F designed the research study and performed the research; Boemio A, Sieczak A, and Piscopo D analyzed the data and wrote the manuscript; Colò G and Fusini F share co-last authorship, and they revised the text of the manuscript; and all authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Comitato Etico dell’Istituto Clinica Ortopedica AOU Luigi Vanvitelli, Campania.
Informed consent statement: This is to certify that signature of a consent form for the study was waived by our Institutional Review Board for the current study because of its retrospective nature and part of our service evaluation assessment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at boemioale@gmail.com Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Fabio Zanchini, MD, PhD, Professor, Division of Orthopaedics and Traumatology, Multidisciplinary Department of Medical-Surgical and Dental Specialties, Clinical Orthopeadics, University of Campania “Luigi Vanvitelli”, Vico L. de Crecchio, Naples 80138, Italy. fabio.zanchini@unicampania.it
Received: August 10, 2023
Peer-review started: August 10, 2023
First decision: September 28, 2023
Revised: October 12, 2023
Accepted: November 17, 2023
Article in press: November 17, 2023
Published online: December 18, 2023
ARTICLE HIGHLIGHTS
Research background
Several minimally invasive surgical techniques for the correction of hallux valgus (HV) have emerged in the literature. These techniques concern the distal osteotomy of the first metatarsal, the use or not of internal fixation, osteotomy of the base of the first phalanx (Akin osteotomy). All these techniques can be associated with the lateral release of soft tissues.
Research motivation
The lack of copious prospective studies regarding lateral soft tissues release (LSTR) procedure.
Research objectives
The object of this study is to evaluate the role of LSTR on percutaneous HV correction, evaluating functional and radiographical results.
Research methods
From January 2012 to May 2016, a total of 396 patients with mild to moderate symptomatic HV treated with the MIS technique were included in this retrospective study. The technique provides no internal fixation. Patients were divided into the LSTR group (LSTR Y) and no LSTR group (LSTR N). This surgical procedure (LSTR) was reserved for insufficient HV angle (HVA) correction during fluoroscopic control. Patients were evaluated at each follow-up by two other authors after appropriate training by senior authors (first practitioners).
Research results
We found a statistically significant difference in range of motion between the two groups (LSTR-N and LSTR-Y) at 6 mo (P = 0.018423) and the last follow-up (P = 0.02). There are no significant differences between groups for the other parameters assessed (HVA, intermetatarsal angle, American Orthopaedic Foot and Ankle Society, visual analog scale).
Research conclusions
LSTR does not seem to affect pathology relapse, while the adequate correction of HVA remains the crucial factor. LSTR seems to increase postoperative joint stiffness with a comparable incidence of relapse and a low incidence of complications.
Research perspectives
Because of the lack of copious prospective studies regarding LSTR procedure, we feel a more thorough literature review is presented with both prospective and retrospective analyses. The results of this study should be useful to surgeons treating this condition and can be used in the design of future investigations into the joint stiffness.
