The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons · 2026
Impact of first metatarsal capital fragment translation on complication and osseous healing after minimally invasive bunionectomy.
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Frey Christian P, Higinbotham Sean E, Gorski Matthew A, Jerabek Morgan R, Hoffman Kristine M
Аннотация
BACKGROUND: Minimally invasive bunion surgery relies on controlled lateral translation of the first metatarsal capital fragment, but the relationship between translation magnitude and postoperative outcomes remains unclear.
PURPOSE: To evaluate the association between percentage lateral translation of the first metatarsal capital fragment and postoperative complications following minimally invasive bunionectomy. Secondary aims included radiographic union, first metatarsal regeneration patterns, and preoperative deformity severity.
STUDY DESIGN: Retrospective cohort study.
METHODS: Sixty-two consecutive minimally invasive bunionectomy procedures performed in 53 patients were retrospectively reviewed. Mean follow-up was 8.3 ± 6.5 months. Outcomes included hardware-related complications, wound complications, revision surgery, radiographic union, and metatarsal regeneration patterns. Translation was analyzed as a continuous variable and by a threshold of ≥100% versus <100% of metatarsal shaft width.
RESULTS: Hardware-related complications occurred in 26% (16/62) of procedures. Translation ≥100% was associated with a higher complication rate than <100% translation (3/5 [60%] vs 13/57 [23%]; OR 4.61, p = 0.080). No statistically significant association was identified between translation percentage and complications across the cohort. Radiographic union occurred in 94% (58/62) of cases and was not influenced by translation magnitude. Increasing translation was not significantly associated with first metatarsal regeneration type nor was preoperative deformity severity associated with complication risk.
CONCLUSION: Complete loss of cortical apposition, ≥100% translation, was associated with higher observed hardware-related complication rates, although this finding did not reach statistical significance and was based on a small subgroup (n = 5). These results warrant further investigation in larger studies to define safe limits of capital fragment translation.
PURPOSE: To evaluate the association between percentage lateral translation of the first metatarsal capital fragment and postoperative complications following minimally invasive bunionectomy. Secondary aims included radiographic union, first metatarsal regeneration patterns, and preoperative deformity severity.
STUDY DESIGN: Retrospective cohort study.
METHODS: Sixty-two consecutive minimally invasive bunionectomy procedures performed in 53 patients were retrospectively reviewed. Mean follow-up was 8.3 ± 6.5 months. Outcomes included hardware-related complications, wound complications, revision surgery, radiographic union, and metatarsal regeneration patterns. Translation was analyzed as a continuous variable and by a threshold of ≥100% versus <100% of metatarsal shaft width.
RESULTS: Hardware-related complications occurred in 26% (16/62) of procedures. Translation ≥100% was associated with a higher complication rate than <100% translation (3/5 [60%] vs 13/57 [23%]; OR 4.61, p = 0.080). No statistically significant association was identified between translation percentage and complications across the cohort. Radiographic union occurred in 94% (58/62) of cases and was not influenced by translation magnitude. Increasing translation was not significantly associated with first metatarsal regeneration type nor was preoperative deformity severity associated with complication risk.
CONCLUSION: Complete loss of cortical apposition, ≥100% translation, was associated with higher observed hardware-related complication rates, although this finding did not reach statistical significance and was based on a small subgroup (n = 5). These results warrant further investigation in larger studies to define safe limits of capital fragment translation.