Osteotomía en tejadillo (“Chevron”) con técnica MIS (“Minimally invasive surgery”) del primer metatarsiano.

• Autores: Javier Del Vecchio, Mauricio Esteban Ghioldi, Nicolás Raimondi
• Localización: Revista de la Asociación Argentina de Ortopedia y Traumatología, ISSN 1852-7434, Vol. 82, Nº. 1, 2017, págs. 19-27
• Idioma: español
• DOI: 10.15417/633
• Títulos paralelos:
  • Chevron osteotomy with minimally invasive surgery (MIS) of the first metatarsal.
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• Resumen
  • español

    ObjetivoEl objetivo del presente estudio, fue analizar los resultados radiológicos de una osteotomía en tejadillo (“Chevron”) con técnica MIS (Minimally invasive surgery) del primer metatarsiano en una población uniforme de pacientes (hallux valgus moderado).Material y MétodosEntre octubre del año 2013 y noviembre del año 2014, se realizó el tratamiento quirúrgico del hallux valgus mediante una osteotomía en tejadillo (“Chevron”) con técnica MIS del primer metatarsiano en 24 pies correspondientes a 21 pacientes. Todos los pacientes presentaban diagnóstico de hallux valgus moderado.ResultadosEl ángulo intermetatarsiano entre primero y segundo metatarsiano preoperatorio promedio fue de 12,46°  (Rango: 11 a  15°; Desvío estándar o DE 1,03). En el postoperatorio se obtuvo el siguiente valor promedio: 8,13° (Rango: 5 a 10°; DE 1,16). La corrección angular fue de 4,33° promedio. El ángulo de hallux valgus preoperatorio promedio fue de  33,96° (Rango: 20 a 40°; DE 4,93). En el postoperatorio, el ángulo metatarsofalángico fue de 8,16° promedio, con rango entre 3° y 15° y con un DE 2,86. La mejoría promedio del ángulo MTF fue de 25,86°.DiscusiónLa corrección radiológica obtenida mediante la técnica mínimamente invasiva de la osteotomía en “tejadillo” confirma un seguro y efectivo procedimiento  para el tratamiento del hallux valgus moderado, con correcciones angulares satisfactorias a mediano plazo. El mencionado procedimiento remeda de manera fidedigna la técnica quirúrgica abierta con todas sus virtudes conocidas y no fue encontrado estudio equivalente en la bibliografía.

  • English

    BackgroundThe aim of this study was to analyze the radiological results of a roof (“Chevron”) osteotomy with MIS (Minimally invasive surgery) technique of the first metatarsal in a uniform population of patients with moderate hallux valgus.MethodsSurgical treatment of hallux valgus was performed between October 2013 and November 2014, by a roof ("Chevron") osteotomy with MIS technique of the first metatarsal in 24 feet of 21 patients. All patients had a diagnosis of moderate hallux valgus.ResultsThe mean preoperative intermetatarsal angle between M1-M2 was 12.46° (range: 11-15°, SD 1.03). Postoperatively, the mean intermetatarsal angle was 8.13° (range: 5-10°; SD 1.16), with an angular correction of 4.33° in average. The mean preoperative hallux valgus angle was 33.96° (range: 20-40°; SD 4.93) and postoperatively, the metatarsal-phalangeal angle was 8.16° in average, (range: 3-15°, SD 2.86), thus improving in 25.86° in average.ConclusionsRadiological results obtained from the minimally invasive technique (Chevron osteotomy), confirm a safe and effective procedure for the treatment of moderate hallux valgus, with mid-term satisfactory angular correction. This method faithfully mimics the open Chevron surgical  technique retaining all its known virtues. To our knowledge, no equivalent study was found in the literature.

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