Hospital Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil (GN).
GRECMIP, MIFAS (Groupe de Recherche et d'Etude en Chirurgie Mini-Invasive du Pied-Minimally Invasive Foot and Ankle Society), Mérignac, France (GN, PC, GC).
Foot Ankle Spec. 2022 Feb;15(1):36-42. doi: 10.1177/1938640020937501. Epub 2020 Jul 1.
. Bunionette is a deformity of the fifth metatarsal in which there is a painful lateral bony prominence of the distal region of this bone caused by various anatomical and biomechanical changes. The aim of this study is to report on a minimally invasive technique without the use of hardware to treat these deformities. . This is a case series of 18 patients, 25 feet, who underwent bunionette percutaneous surgical treatment. All patients answered the American Orthopaedic Foot and Ankle Society (AOFAS) scale and the visual analogue pain scale (VAS) preoperatively and at the last follow-up. Standard radiological evaluation included measurement of intermetatarsal (4-5 IMA) and fifth toe metatarsophalangeal (5-MTTP) angles. Time to radiographic consolidation, complications, and satisfaction rate were also documented. . The average follow-up was 15.9 months, the AOFAS increased from 49.6 to 92.4 and the VAS decreased from 7.7 to 1.2. It was observed that average 5-MTTP decreased from 15° to 2.7° and that 4-5-IMA decreased from 9.1° to 3.3°. These outcomes showed a statistically significant difference ( < .001). The most common observed complication was the formation of a hypertrophic bone callus in the third postoperative month in three operated feet (12%). One patient had algodystrophy, which improved after conservative treatment. There were no cases of infection, neuropraxis, or recurrences. Fifteen patients rated the result as excellent, 2 as good, and 2 as regular. . Percutaneous osteotomy of the fifth metatarsal without the use of hardware is a safe, reproducible technique and presents good clinical and radiographic results for the treatment of bunionette. Therapeutic studies, Level IV: Case series.
. 小脚趾囊炎是第五跖骨的一种畸形，由于各种解剖和生物力学的变化，导致该骨远端区域出现疼痛性外侧骨突出。本研究旨在报告一种微创技术，无需使用内固定即可治疗这些畸形。. 这是一项对 18 名患者（25 只脚）行小脚趾囊炎经皮手术治疗的病例系列研究。所有患者均在术前和末次随访时回答了美国矫形足踝协会（AOFAS）量表和视觉模拟疼痛量表（VAS）。标准影像学评估包括测量跖骨间（4-5 IMA）和第五跖趾关节（5-MTTP）角度。还记录了影像学愈合时间、并发症和满意度。. 平均随访时间为 15.9 个月，AOFAS 评分从 49.6 分增加到 92.4 分，VAS 评分从 7.7 分降低到 1.2 分。观察到平均 5-MTTP 从 15°减少到 2.7°，4-5-IMA 从 9.1°减少到 3.3°。这些结果具有统计学显著差异（<.001）。最常见的并发症是术后 3 个月时 3 只手术足出现的肥大性骨痂形成（12%）。1 例患者出现了反射性交感神经营养不良，经保守治疗后得到改善。无感染、神经损伤或复发病例。15 例患者将结果评为优秀，2 例评为良好，2 例评为一般。. 不使用内固定的第五跖骨经皮截骨术是一种安全、可重复的技术，为治疗小脚趾囊炎提供了良好的临床和影像学结果。治疗研究，IV 级：病例系列研究。
