Periarticular soft tissue effect following fourth generation MIS Hallux Valgus correction: Formation of a pyramid-shaped first metatarsal osseous healing zone

Abstract

Literature of fourth-generation minimally invasive surgery (MIS) on hallux valgus is scarce. In this study, extra-capsular transverse osteotomies were performed on ten cadaveric specimens. The capital fragment was shifted lateral to nearly 100% of the first metatarsal width and then fixated in contemporary fashion following MIS principles. A mixture of radio-opaque solution and methylene blue dye was injected through the second screw hole into the pyramid-shaped space created after the osteotomy shift. The injection was visualized under fluoroscopy and specimen were dissected in layered fashion to assess for containment versus extravasation. The purpose of this study is to observe and describe the preservation of the joint capsule, periosteum, and soft tissue structures adjacent to the osteotomy.