Department of Orthopaedic Surgery, Chiba Aiyukai Memorial Hospital, Nagareyama City, Chiba, Japan.
J Foot Ankle Surg. 2021 Sep-Oct;60(5):1079-1087. doi: 10.1053/j.jfas.2021.05.003. Epub 2021 May 14.
Bunionette deformities have been treated as an analog of hallux valgus, and the surgical techniques are similar. Most commonly anteroposterior image is evaluated pre- and postoperatively. To our knowledge, only one study has evaluated changes on the lateral radiograph and no study has evaluated changes in rotation of the fifth metatarsal head postoperatively. In percutaneous bunionette correction using a burr for osteotomy, shortening of the fifth metatarsal and elevation of the metatarsal head are inevitable. Without fixation, there is also a possibility of rotational change to the metatarsal head. We measured parameters on anteroposterior and lateral weightbearing radiographs in 18 feet pre- and postoperatively. Rotation of the fifth metatarsal head was graded according to the medial tubercle location. We also evaluated angular change of the fifth metatarsal on weightbearing lateral radiographs. Percutaneous bunionette correction without fixation could achieve satisfactory clinical and radiographic results, with less complication, when compared with previously published outcomes of open and percutaneous surgery with fixation. In this surgical method, bunionette is corrected in 3 dimensions. To our knowledge, this is the first study to evaluate rotation of the metatarsal head and change in the sagittal angle of the fifth metatarsal after bunionette correction.
囊炎畸形一直被视为拇外翻的类似病症，手术技术也相似。最常见的是评估术前和术后的前后影像。据我们所知，只有一项研究评估了外侧射线照相的变化，而没有研究评估术后第五跖骨头旋转的变化。在使用磨头进行经皮囊炎矫正的手术中，第五跖骨缩短和跖骨头抬高是不可避免的。如果没有固定，跖骨头也有可能发生旋转变化。我们在 18 只脚的前后负重射线照相上测量了术前和术后的参数。根据内侧结节的位置对第五跖骨头的旋转进行分级。我们还评估了负重侧位射线照相上第五跖骨的角度变化。与先前发表的开放性和经皮固定手术的结果相比，经皮囊炎矫正术无需固定即可获得令人满意的临床和放射学结果，且并发症更少。在这种手术方法中，囊炎以 3 个维度进行矫正。据我们所知，这是第一项评估囊炎矫正后跖骨头旋转和第五跖骨矢状角变化的研究。
