Minimally Invasive Chevron-Akin osteotomy for Correction of Moderate and Severe Hallux Valgus Deformities: An Anatomical, Clinical and Radiological Study
[eng] INTRODUCTION: Minimally invasive surgical (MIS) treatment of hallux valgus (HV) deformities has experienced exponential growth in the last decade. Many studies on this technique have been published, including clinical series, comparative studies, technical reports, radiologic validations, and...
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| Tipo de recurso: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Universidad de Barcelona |
| Repositorio: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/224577 |
| Acceso en línea: | https://hdl.handle.net/2445/224577 http://hdl.handle.net/10803/695792 |
| Access Level: | acceso abierto |
| Palabra clave: | Cirurgia ortopèdica Cirurgia podològica Malalties del peu Anatomia topogràfica Malformacions del peu Orthopedic surgery Foot surgery Foot diseases Surgical and topographical anatomy Foot abnormalities |
| Sumario: | [eng] INTRODUCTION: Minimally invasive surgical (MIS) treatment of hallux valgus (HV) deformities has experienced exponential growth in the last decade. Many studies on this technique have been published, including clinical series, comparative studies, technical reports, radiologic validations, and systematic reviews. Vernois and Redfern described the minimally invasive chevron-Akin (MICA). This technique combines percutaneous osteotomies with the benefits of modern rigid internal fixation. In addition, it minimizes soft tissue and vascular disruption while allowing a lateral translation of the metatarsal head to nearly 100%. This is possible by maintaining only the medial cortical contact of the head with the lateral cortex of the metadiaphyseal region. This procedure can be indicated for symptomatic mild to moderate HV deformity, and with experience, severe deformity corrections can be corrected using nearly 100% displacement of osteotomy. Because this surgical procedure has a significant learning curve and is performed under fluoroscopy without direct visualization of the anatomical structures, there is a theoretically increased risk of injury to blood vessels, tendons, and nerves close to the osteotomy compared with open surgery. HYPOTHESIS: The MICA technique would maintain clinical and radiographic improvement in a minimum follow-up of 2 years, while the minimally invasive chevron osteotomy would be able to preserve the soft tissue envelope and vascular supply of the first metatarsal head complex and minimize iatrogenic injury. OBJECTIVES: First, the main objective of our project is to comprehensively evaluate the clinical efficacy and radiographic outcomes of the MICA technique in the surgical correction of moderate to severe hallux valgus. Second, through detailed cadaveric analysis, the research aims to assess the incidence of injury to the soft tissue envelope (tendons and nerves) surrounding the first metatarsal head complex and the blood supply to the first metatarsal head, as well as to establish a safe position near the first metatarsal head to perform MIS chevron osteotomy. |
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