A Joy-Stick Assistant Three-Dimensional Modified Technique of Minimally Invasive Surgery for Mild or Moderate Hallux Valgus

BackgroundMinimally invasive surgery (MIS) such as minimally invasive chevron osteotomy and Akin osteotomy (MICA) has become popular in the treatment of hallux valgus. However, how to correct three-dimensional deformities in hallux valgus effectively and simply in MICA is still difficult. Special equipment is required in MICA as has been reported before. It is meaningful and necessary to reduce the reliance on special equipment in MICA.MethodsFrom January 2021 to July 2022, patients with mild or moderate hallux valgus were treated with a joy-stick assistant three-dimensional modified technique (Joy-stick 3D technique) of MIS. VAS, AOFAS Hallux MTP-IP scores, hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) were measured pre- and postoperatively at the last follow-up of at least 6 months. Scores and radiologic angles were compared using paired sample t-test.ResultsA total of 36 cases were included. HVA, IMA, and DMAA were (22.3 +/- 6.1)degrees, (14.0 +/- 3.2)degrees, and (8.9 +/- 3.2)degrees preoperatively, and decreased to (7.0 +/- 1.8)degrees, (3.7 +/- 1.0)degrees, and (3.3 +/- 1.1)degrees postoperatively. VAS decreased from 4.3 +/- 1.7 to 0.7 +/- 0.7. AOFAS Hallux MTP-IP scores improved from 68.6 +/- 7.6 to 92.9 +/- 6.1. Comparing mild and moderate cases, though HVA, IMA, and DMAA were significantly different preoperatively, the angles became statistically similar after surgery.ConclusionsA joy-stick assistant three-dimensional modified technique is proposed to control the three-dimensional position of the metatarsal head and to reduce dependence on special tools. Mild and moderate hallux valgus deformities are effectively corrected using Joy-stick 3D technique. The paper describes a joy-stick assistant three-dimensional modified technique of minimally invasive surgery for hallux valgus. The series of X-rays shows the surgical procedure and unique reduction of hallux valgus using towel forceps. image