Time to Callus Formation With Minimally Invasive Bunion Surgery: Association of Intramedullary Plate Fixation With Earlier Consolidation Compared to Screw Fixation Techniques.

BACKGROUND: Hallux valgus (HV) remains a common forefoot deformity with a global prevalence of 19%. It is largely agreed that surgical correction of HV with minimally invasive techniques have good outcomes. Options include the percutaneous minimally invasive screw fixation (SF) and the intramedullary plate fixation (IPF) technique, with both employing different fixation techniques and hence stability of fixation. In this article, we aim to compare these 2 minimally invasive correction techniques and analyze the radiologic and clinical outcomes, including their time to consolidation.

METHODS: A retrospective study was conducted using data from a single tertiary hospital involving 89 feet who underwent SF (n = 42) and IPF (n = 47) procedures. Radiologic grading of callus formation was determined based on 2 components, the visualization of callus formation and the obliteration of the fracture line. Sequential radiographs were evaluated postoperatively across a 6-month period looking for callus formation.

RESULTS: A Fisher exact test was performed to examine the relation between both surgical procedures and the grade of callus formation. At 6 months, full callus formation was seen in both methods. However, at 3 months, there was a statistically significant difference between the 2 methods (P ≤ .05). IPF showed higher grades of callus formation than those in the SF group. In comparing the 2 groups, IPF also showed higher rates of full callus formation than those of the SF group (P ≤ .05).

CONCLUSION: IPF of HV appears to be associated with faster callus formation at 3 months postoperatively than SF, with a greater proportion showing full callus formation.

LEVEL OF EVIDENCE: Level III, retrospective cohort study.