CENTRUM
ORTHOPEDIE ARTIKELS ABSTRACT 1 Bunionette- is there a minimally invasive solution? Michels F, Guillo S Foot Ankle Clinics of North America, 2020, 25(3), 425-439
ABSTRACT A bunionette deformity, is a painful prominence on the lateral aspect of the fifth metatarsal head. Surgical treatment can be considered if conservative treatment has failed to relieve the symptoms. The percutaneous approach consists of 2 steps: a condylectomy and an osteotomy of the fifth metatarsal. The clinical and radiographic results are similar to conventional open procedures. The learning curve is small and the final results are similar to the open techniques. The main advantages is are the hardware free technique and the minimally invasive approach. This percutaneous approach avoids complications related to hardware and soft tissue healing. Due to this low complication rate the percutaneous technique may become the new gold standard.
MATERIALS/METHODS A survey was sent to 50 orthopedic surgeons with specific experience in percutaneous techniques. The questions were related to different aspects of the surgical bunionette procedure and the perioperative protocol.
RESULTS A response rate of 92.0 % was obtained. Several points of agreement were found. A condylectomy is rarely used while an osteotomy is performed in almost all procedures. This osteotomy is single (95.7%), complete (66.2-72.7%) and performed with a Shannon long burr (73.9%). The location of the osteotomy depends of the deformity (63.0%).
CONCLUSION This study demonstrates some consensus in the use of the surgical technique and the peri operative protocol. The percutaneous oblique osteotomy is the preferred technique while a condylectomy is only rarely used.
ABSTRACT 3 Does subtalar instability really exist? A systematic review. Michels F, Clockaerts S, Van Der Bauwhede J, et al. Foot and Ankle Surgery, 2020, 26(2), 119-127
ABSTRACT 2 Consensus in percutaneous bunionette correction. Michels F, Demeulenaere B, Cordier G Orthopedics Traumatoly Surgery Research, 2020, DOI: 10.1016/j.otsr.2020.03.029
INTRODUCTION Subtalar joint instability (STI) is considered as a potential source of chronic lateral hindfoot instability. However, clinical diagnosis of STI is still challenging.
OBJECTIVE INTRODUCTION The percutaneous treatment of bunionette deformity has been demonstrated as a reliable and satisfying technique with low risk of complications. However, there are some obvious variations in the surgical technique and perioperative protocol.
OBJECTIVE The purpose of this study is to analyze the currently used techniques and to look for some agreements.
HYPOTHESIS There are some points of agreement in surgical technique and perioperative protocol when using a percutaneous technique to treat bunionette deformity.
This systematic review was conducted to assess the consistency of the clinical entity "subtalar instability", to investigate the reliability of available diagnostic tools and to provide a critical overview of related studies.
MATERIALS/METHODS A systematic review of the Medline, Web of Sciences and EMBASE databases was performed for studies reporting on tests to investigate subtalar instability or lesions of the subtalar ligaments. To investigate the relation with chronic STI, studies focusing on sinus tarsi syndrome (STS) or acute lesions of the subtalar ligaments were also included in the search strategy and were assessed separately.
ORTHOPEDIE
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