Study Results
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Basic Information
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COMPLETED
NA
29 participants
INTERVENTIONAL
2018-03-10
2018-08-25
Brief Summary
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To our knowledge, there is no report regarding HV treatment using SERI from Saudi Arabia or in any part of the Middle East. Therefore, this study conducted to determine the radiological measurements done preoperatively and compare the measurements done at one year postoperatively, recording the complication happened and measuring the cost effectiveness of such procedure.
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Detailed Description
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Because of the concomitant pain and other functional disability with HV, surgery is indicated usually depending on the degree of deformity based on the radiological findings as well as the physical examination findings. Radiological assessment includes weight-bearing anteroposterior (AP) and lateral imaging of the foot. The severity of the deformity is usually classified as mild, when the hallux valgus angle (HVA) is up to 19o , intermetatarsal angle (IMA) up to 13o; moderate when HVA is 20o to 40o; and severe when HVA is \>40o and IMA \>20o.
There were a multitude of modern concepts in the surgical treatment of HV, including the Keller's procedure, the distal soft-tissue procedure, osteotomies of the first metatarsal, distal metatarsal osteotomies (Wilson procedure, Mitchell osteotomy, distal Chevron osteotomy), and many other type of surgeries including diaphyseal osteotomies and arthrodesis. Most of these surgical procedures were shown to provide morphologic and functional re-balance after surgery. While there are more than 150 surgical procedures described to treat HV, none of them is considered as a gold standard and each one had it is own advantages and disadvantages.
Minimally invasive techniques for correction of HV include arthroscopy, percutaneous and minimum incision surgery which were found to provide better outcome by decreasing recovery and rehabilitation time. On the other hand, some authors suggested that to correct HV deformity using SERI, a lateral soft tissue release should be performed first and reposition the sesamoids to avoid recurrence of the HV.
The SERI technique (as abbreviated to stand for simple, effective, rapid and inexpensive) was presented by several authors to be a minimally invasive technique since it presents with the same advantages as the percutaneous techniques with less tissue dissection and a need for only temporary hardware, meaning no instrumentation and surgery is performed under direct vision without fluoroscopy. It is a type of distal first metatarsal osteotomy. Several studies using SERI have shown adequate correction of the deformity without avascular necrosis of the metatarsal head, pseudoarthrosis or recurrence.
Radiographic assessment including angular radiological parameters, sesamoid subluxation, and the articular congruency were shown to prove adequate correction of angular HV deformities. Preoperatively, measuring the axial view of the sesamoid position in the radiographic assessment of HV was proven to guide the surgeon on the appropriate surgical technique. Furthermore, measurements of the HVA and the IMA were recommended to evaluate preoperative assessment of the severity of HV and postoperative outcome of surgical treatment of HV.
Conditions
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Study Design
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NA
SINGLE_GROUP
TREATMENT
NONE
Study Groups
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a minimally invasive surgery (SERI)
The surgery consisted of varus traction, skin incision, metatarsal osteotomy and K- wire insertion. All the cases were done by the senior consultant orthopedic surgeon, including preoperative planning, the osteotomy itself and the follow up in the clinic. Another orthopedic surgeon was involved in collecting the data, doing all the measurements preoperative and postoperative and assisting the primary surgeon during the surgery.
a minimally invasive surgery (SERI)
The SERI technique (as abbreviated to stand for simple, effective, rapid and inexpensive) was presented by several authors to be a minimally invasive technique since it presents with the same advantages as the percutaneous techniques with less tissue dissection and a need for only temporary hardware, meaning no instrumentation and surgery is performed under direct vision without fluoroscopy
Interventions
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a minimally invasive surgery (SERI)
The SERI technique (as abbreviated to stand for simple, effective, rapid and inexpensive) was presented by several authors to be a minimally invasive technique since it presents with the same advantages as the percutaneous techniques with less tissue dissection and a need for only temporary hardware, meaning no instrumentation and surgery is performed under direct vision without fluoroscopy
Eligibility Criteria
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Inclusion Criteria
* Reducible mild or moderate HV, HVA of ≤40o, IMA ≤20o with some severe cases.
* Patient with arthritis of the 1st MTP joint up to grade 2 according to the Regnauld's classification
* At least 2 years of follow-up in the hospital.
Exclusion Criteria
* Patients with severe arthritis of the first MTP joint (more than Regnauld's grade 2)
* Patients with history of rheumatoid arthritis or other inflammatory diseases, diabetics.
* Patients with neurological disorders.
* Patients with prior hallux surgery.
20 Years
60 Years
ALL
No
Sponsors
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Security Forces Hospital
OTHER
Responsible Party
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Raheef Alatassi
Orthopedic Surgeon
Principal Investigators
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Talal Almalki, FRCS
Role: STUDY_DIRECTOR
Security Forces Hospital
Locations
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Security Forces Hospital
Riyadh, , Saudi Arabia
Countries
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References
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Nix S, Smith M, Vicenzino B. Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. J Foot Ankle Res. 2010 Sep 27;3:21. doi: 10.1186/1757-1146-3-21.
Roddy E, Zhang W, Doherty M. Prevalence and associations of hallux valgus in a primary care population. Arthritis Rheum. 2008 Jun 15;59(6):857-62. doi: 10.1002/art.23709.
Robinson AH, Limbers JP. Modern concepts in the treatment of hallux valgus. J Bone Joint Surg Br. 2005 Aug;87(8):1038-45. doi: 10.1302/0301-620X.87B8.16467. No abstract available.
Giannini S, Cavallo M, Faldini C, Luciani D, Vannini F. The SERI distal metatarsal osteotomy and Scarf osteotomy provide similar correction of hallux valgus. Clin Orthop Relat Res. 2013 Jul;471(7):2305-11. doi: 10.1007/s11999-013-2912-z. Epub 2013 Mar 14.
Maffulli N, Longo UG, Marinozzi A, Denaro V. Hallux valgus: effectiveness and safety of minimally invasive surgery. A systematic review. Br Med Bull. 2011;97:149-67. doi: 10.1093/bmb/ldq027. Epub 2010 Aug 14.
Wu GB, Yang YF, Yu GR, Li B. Comment on Giannini et al.: A minimally invasive technique for surgical treatment of hallux valgus: simple, effective, rapid, inexpensive (SERI). Int Orthop. 2014 Mar;38(3):671-2. doi: 10.1007/s00264-013-2209-6. Epub 2013 Dec 5. No abstract available.
Giannini S, Faldini C, Nanni M, Di Martino A, Luciani D, Vannini F. A minimally invasive technique for surgical treatment of hallux valgus: simple, effective, rapid, inexpensive (SERI). Int Orthop. 2013 Sep;37(9):1805-13. doi: 10.1007/s00264-013-1980-8. Epub 2013 Jul 3.
Wagner E, Ortiz C, Torres K, Contesse I, Vela O, Zanolli D. Cost effectiveness of different techniques in hallux valgus surgery. Foot Ankle Surg. 2016 Dec;22(4):259-264. doi: 10.1016/j.fas.2015.11.004. Epub 2015 Dec 2.
Trnka HJ, Krenn S, Schuh R. Minimally invasive hallux valgus surgery: a critical review of the evidence. Int Orthop. 2013 Sep;37(9):1731-5. doi: 10.1007/s00264-013-2077-0. Epub 2013 Aug 29.
Lin YC, Cheng YM, Chang JK, Chen CH, Huang PJ. Minimally invasive distal metatarsal osteotomy for mild-to-moderate hallux valgus deformity. Kaohsiung J Med Sci. 2009 Aug;25(8):431-7. doi: 10.1016/S1607-551X(09)70538-8.
Thordarson D, Ebramzadeh E, Moorthy M, Lee J, Rudicel S. Correlation of hallux valgus surgical outcome with AOFAS forefoot score and radiological parameters. Foot Ankle Int. 2005 Feb;26(2):122-7. doi: 10.1177/107110070502600202.
Nery C, Coughlin MJ, Baumfeld D, Ballerini FJ, Kobata S. Hallux valgus in males--part 2: radiographic assessment of surgical treatment. Foot Ankle Int. 2013 May;34(5):636-44. doi: 10.1177/1071100713475351. Epub 2013 Jan 30.
Catanese D, Popowitz D, Gladstein AZ. Measuring sesamoid position in hallux valgus: when is the sesamoid axial view necessary? Foot Ankle Spec. 2014 Dec;7(6):457-9. doi: 10.1177/1938640014539804. Epub 2014 Jul 7.
Shima H, Okuda R, Yasuda T, Jotoku T, Kitano N, Kinoshita M. Radiographic measurements in patients with hallux valgus before and after proximal crescentic osteotomy. J Bone Joint Surg Am. 2009 Jun;91(6):1369-76. doi: 10.2106/JBJS.H.00483.
Coughlin MJ, Freund E. Roger A. Mann Award . The reliability of angular measurements in hallux valgus deformities. Foot Ankle Int. 2001 May;22(5):369-79. doi: 10.1177/107110070102200503.
Almalki T, Alatassi R, Alajlan A, Alghamdi K, Abdulaal A. Assessment of the efficacy of SERI osteotomy for hallux valgus correction. J Orthop Surg Res. 2019 Jan 24;14(1):28. doi: 10.1186/s13018-019-1067-3.
Other Identifiers
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Hallux Valgus and SERI
Identifier Type: -
Identifier Source: org_study_id
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