To The Editor:
I read with interest the paper entitled “Percutaneous Distal Metatarsal
Osteotomy for Correction of Hallux Valgus” (2005;87:1191-1199) by Magnan,
et al. The authors deserve to be complimented for a scientific study on a
topic about which very little has been published.
Additionally, I agree
with the comments of Coughlin and Grimes (1) regarding the advantages of
minimally invasive surgery to reduce the likelihood of necrosis of the
metatarsal head. However, complications of minimally invasive procedures
associated with injuries of vessels, nerves or tendons stated by Coughlin
and Grimes seem to be supported by an editorial of Weil (2), although no
bibliographic reference was included in this paper.
In my experience using
a careful percutaneous Reverdin-Isham-Akin technique in more than 3,000
patients undergoing hallux valgus correction, not only did none of these
complications occur, but also a satisfactory clinical outcome was observed (3,4). In order to avoid lesions of vessels,
nerves or tendons it is important to pay attention to the surgical
approach and protect the tissues with retractors, and use fluoroscopic control to perform the osteotomy.
References:
1. Coughlin M. Grimes JS. Commentary and Perspective on Percutaneous
Distal Metatarsal Osteotomy for Correction of Hallux Valgus. J Bone J Surg
June 2005. http//www.jbjs.org/Comments/2005/cp_jun05_coughlin.shtml
2. Weil LS. Minimal invasive surgery of the foot and ankle. J Foot Ankle
Surg. 2001;40:61.
3. Pique-Vidal C. The effect of temperature elevation during discontinuous
use of rotatory burrs in the correction of hallux valgus. J Foot Ankle.
Surg. 2005; 44:336-44.
4. Pique-Vidal C. Foot thickness and swelling after hallux valgus
correction with the Reverdin-Isham procedure: a 4-month follow-up study.
Foot Ankle Surg. 2005;11:35-39.
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