ORTHOPEDIE

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.

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 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. 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

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 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.

RESULTS This review identified 25 studies focusing on different topics: chronic STI (16), acute lesions of the subtalar ligaments (5) and STS (4). Twelve studies, assessing STI, demonstrated the existence of a subgroup with instability complaints related to abnormal increased subtalar motion (7) or abnormalities of the subtalar ligaments (6). We found insufficient evidence for measuring subtalar tilting using stress radiographs. MRI was able to assess abnormalities of the ligaments and stress-MRI detected abnormally increased motion.

CONCLUSION Complaints of instability can be related to subtalar ligaments injuries and an abnormally increased motion of the subtalar joint. Stress radiographs should be interpreted with caution and should not have the status of a reference test. Clinical diagnosis should rely on several parameters including MRI. ABSTRACT 7

Pearls in MIS hammertoe surgery.

Michels F

October 2020, Minimally Invasive Surgery Virtual Course American Orthopaedic Foot and Ankle Society, USA, Online

ABSTRACT 8

MIS postoperative care.

Michels F

May 2020, 10th GRECMIP MIFAS Webinar “MIS: postoperative care and complications”, Online

ABSTRACT 4

An oblique fibular tunnel is recommended when reconstructing the ATFL and CFL.

Michels F, Matrical, G, Vanrietvelde F, Stockmans F, et al. Knee Surgery, Sports Traumatology, Arthroscopy, 2020, 28(1), 124-131

Zie Medische beeldvorming pagina 43.

PRESENTATIES

ABSTRACT 5

Ankle instability: surgical decisions – indications, technique, subtalar and Chopart instability.

Michels F

November 2020, Hindfoot instability meeting Belgian Foot and Ankle Society, National webinar

ABSTRACT 6

Complications in MIS hammertoe surgery.

Michels F

October 2020, Minimally Invasive Surgery Virtual Course American Orthopaedic Foot and Ankle Society, USA, Online