Minimally invasive-percutaneous surgery - recent developments of the foot surgery techniques

I Botezatu, R Marinescu, D Laptoiu, I Botezatu, R Marinescu, D Laptoiu

Abstract

Percutaneous techniques are currently more and more used in many surgical procedures on the soft tissues and bones of the foot. Practical advantages include lower complication rates and faster recovery times. Potential disadvantages are related to the need for specific equipment and extensive learning curve. One of the most frequent techniques involves a combination of chevron osteotomy of the first metatarsal with osteotomy of the first phalanx, both internally fixated. Lateral metatarsal misalignment and toe deformities can also be addressed by percutaneous treatment, with lower morbidity rates than open techniques. The most commonly performed percutaneous procedures are described, with their current indications, outcomes, and recent developments.

Keywords: foot surgery techniques; hallux valgus treatment; intermetatarsal angle; minimally invasive–percutaneous surgery; osteotomies.

Figures

Fig. 1
Fig. 1
Intraoperative aspect under fluoroscopic control performing first metatarsal osteotomy
Fig. 2
Fig. 2
Traction and compression forces are applied along the axis of the toe for mobilization of the osteotomy and efficiency control
Fig. 3
Fig. 3
Specialized tools: from left to right – high speed burr, rasp and beaver blade
Fig. 4
Fig. 4
Strapping technique for postoperative dressing
Table 1
Table 1
Comparison between the two most used metatarsal osteotomies
Fig. 5
Fig. 5
Postoperative control after claw toes minimally invasive surgery; bridging skin sutures can be a valuable surgical artifice

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