Lee Jeong Hwan, Kang Taebyeong, Yoo Tae Wook, Lee Dongoh, Seo Sang Gyo
Department of Orthopedic Surgery, SNU Seoul Hospital, 237 Gonghang-Daero, Gangseo-Gu, Seoul, 07803, Korea.
J Orthop Surg Res. 2025 Nov 10;20(1):980. doi: 10.1186/s13018-025-06361-3.
Hallux valgus is one of the most common forefoot deformity, leading to impaired mobility and reduced quality of life. Minimally invasive surgical techniques offer potential advantages, including reduced soft tissue disruption and accelerated postoperative recovery. The present study aimed to assess the clinical and radiographic outcomes of Minimally Invasive Distal Transverse Metatarsal Osteotomy combined with Akin Osteotomy (MITA) in a large patient cohort.
A retrospective review was performed on 493 feet treated with MITA between March 2020 and December 2021 at a single orthopedic center. Radiographic parameters-including hallux valgus angle (HVA), intermetatarsal angle (IMA), sesamoid position, and foot width-were evaluated preoperatively and at multiple postoperative points up to one year. Clinical outcomes were assessed by the Visual Analog Scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) score, and the Manchester-Oxford Foot Questionnaire (MOXFQ), including each domain. Complications were classified into three grades according to severity. Statistical analysis included paired t-tests and repeated measures using a general linear model.
Significant improvements were demonstrated across all radiographic and clinical parameters. Mean HVA decreased from 34.24° to 8.38°, and IMA from 12.67° to 5.78° (p < 0.001). Cases with grade 3 sesamoid displacement decreased markedly, from 424 to 5. Clinical outcomes also improved substantially: VAS scores declined from 2.91 to 0.20, AOFAS scores increased from 82.20 to 99.11, and MOXFQ scores decreased from 36.02 to 4.39 (all p < 0.001). The majority of complications were minor (Grade 1), with transient neurapraxia being the most frequent (6.0%). Severe complications (Grade 3) were uncommon and manageable.
MITA provides effective correction of hallux valgus, achieving excellent radiographic alignment and favorable clinical outcomes. Its minimally invasive approach facilitates rapid postoperative recovery and is associated with a low complication profile, supporting its role as a viable alternative to conventional open procedures and previous generation MIS techniques.
This study was approved by the Korea National Institute for Bioethics Policy (KoNIBP) (Approval No. P01-202506-01-028). As participant data were anonymized, the study was retrospectively registered.
拇外翻是最常见的前足畸形之一，会导致活动能力受损和生活质量下降。微创外科技术具有潜在优势，包括减少软组织损伤和加速术后恢复。本研究旨在评估在一大群患者中采用微创远端横断跖骨截骨术联合Akin截骨术（MITA）的临床和影像学结果。
对2020年3月至2021年12月在单一骨科中心接受MITA治疗的493只脚进行回顾性研究。术前以及术后长达一年的多个时间点评估影像学参数，包括拇外翻角（HVA）、跖间角（IMA）、籽骨位置和足宽。通过视觉模拟量表（VAS）、美国矫形足踝协会（AOFAS）评分以及曼彻斯特-牛津足部问卷（MOXFQ）（包括各个领域）评估临床结果。根据严重程度将并发症分为三个等级。统计分析包括配对t检验和使用一般线性模型的重复测量。
所有影像学和临床参数均有显著改善。平均HVA从34.24°降至8.38°，IMA从12.67°降至5.78°（p < 0.001）。3级籽骨移位病例显著减少，从424例降至5例。临床结果也有大幅改善：VAS评分从2.91降至0.20，AOFAS评分从82.20升至99.11，MOXFQ评分从36.02降至4.39（均p < 0.001）。大多数并发症为轻微（1级），最常见的是短暂性神经失用（6.0%）。严重并发症（3级）并不常见且可处理。
MITA能有效矫正拇外翻，实现优异的影像学对线和良好的临床结果。其微创方法有助于术后快速恢复，且并发症发生率低，支持其作为传统开放手术和上一代MIS技术的可行替代方法的作用。
本研究经韩国国家生物伦理政策研究所（KoNIBP）批准（批准号P01-202506-01-028）。由于参与者数据已匿名化，该研究进行了回顾性注册。
