Минимально инвазивная техника против открытой хирургии при молоткообразной деформации второго пальца: сравнение результатов

Abstract

Introduction The use of minimally invasive techniques is of utmost importance to future developments of foot and ankle surgery requiring largescale clinical randomized studies. This retrospective study is based on a comparison of the classical open and minimally invasive techniques. Material and methods The review included 65 hammertoe surgical cases (76 feet) treated with minimally invasive approach and postoperative strapping and taping techniques (group A, n = 39) and with open procedure using transarticular wire fixation (group B, n = 37) . Open surgical procedures were performed for the first metatarsal at the same time for all patients. The mean follow-up period was 15.3 ± 2.8 months. The mean age of patients was 62.8 ± 10.2 years. Results The follow-up protocol included a survey, physical examination, assessment of pain, function and treatment satisfaction (AOFAS, VAS FA, PGIC) and radiographic estimation of fusion. A floating toe was a common complication. Discussion Minimally invasive technique was demonstrated to be a less safe approach (risks associated with burr manipulations and surgeon skills) and more effective (minor and moderate pain in the postoperative period, lower risk of infection, attainment of personal anatomicity and early loading without internal fixation, extended indications with no need for use of surgical tourniquet) demonstrating adequate radiographic and clinical results and high patient satisfaction. The technique promotes patient's comfort and willingness to cooperate due to the lack of internal fixation and has a high intraoperative radiation load compared to other methods. Conclusion Minimally invasive technique has demonstrated good results and can be advocated for extensive orthopaedic practice with its ow n niche of application.