Bunion Correction: "Rotation, Rotation, Rotation!”
Unless you’ve been under a rock, you've heard, "rotation, rotation, rotation" when it comes to hallux valgus correction.
But, does it really matter?
The Real
We simply don’t know. Proponents argue true anatomical correction will allow for long-term maintenance of correction, better function, and a lower rate of complications. The counter argument, if hallux valgus correction has been done for 100 years without de-rotation, then what's really the issue?
New Research
In their study "Association of First Metatarsal Pronation Correction With Patient-Reported Outcomes and Recurrence Rates in Hallux Valgus," Matthew Conti, MD, et al. show for the first time coronal rotation correction in 39 consecutive patients who underwent a modified Lapidus procedure was associated with improved patient reported outcomes and reduced recurrence rates.
Specifically, PROMIS scores at a minimum of two years on postoperative weightbearing CTs were significantly higher by 7.2 points, with reduced loss of first metatarsal rotation.
Let's Think Bigger Picture
If coronal rotation does matter, then the next question becomes: Does it matter where it's done – distally via MIS bunion correction or proximally with first TMTJ fusion?
Food for thought.
Recent Posts
See AllThe supine position is favored among surgeons performing minimally invasive surgery for bunion correction. This can present challenges, however, for hand positioning during burr utilization, angular c
“Clinical and Radiographic Outcomes of Percutaneous Chevron-Akin Osteotomies for the Correction of Hallux Valgus Deformity,” a case series in Foot and Ankle International by Dr. Ettore Vulcano et al.,
One of the most common musculoskeletal surgeries performed, bunion treatment is big business in the US. There is little consensus, however, on the most effective treatment strategy. Osteotomies narrow