Treatment of Bunionette Deformity with S.E.R.I. (simple, effective, rapid, inexpensive) Operation

S.E.R.I. 수술법을 이용한 소건막류의 치료

  • Kim, Sun-Yong (Department of Orthopaedic Surgery, Yonsei University College of Medicine) ;
  • Park, Kwang-Hwan (Department of Orthopaedic Surgery, Yonsei University College of Medicine) ;
  • Lee, Jin-Woo (Department of Orthopaedic Surgery, Yonsei University College of Medicine)
  • 김선용 (연세대학교 의과대학 정형외과학교실) ;
  • 박광환 (연세대학교 의과대학 정형외과학교실) ;
  • 이진우 (연세대학교 의과대학 정형외과학교실)
  • Received : 2010.04.19
  • Accepted : 2010.05.13
  • Published : 2010.06.15

Abstract

Purpose: The purpose of this study was to evaluate the clinical and radiological outcomes of the S.E.R.I. (simple, effective, rapid, inexpensive) operation for the bunionette deformity. Materials and Methods: Between March 2005 and February 2009, 22 patients (26 feet) who had been treated for the bunionette deformity with minimally invasive osteotomy were reviewed retrospectively. Clinically, Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, shoes selectivity, disappearance of callus and patient's satisfaction level by Coughlin scoring system were evaluated. Radiologically, the bunionette was classified as four types according to the Fallat classification. The 4-5$^{th}$ intermetatarsal angle (4-5$^{th}$ IMA), the 5$^{th}$ metatarsophalangeal angle (5$^{th}$ MPA) and the length of 5th metatarsal bone (5$^{th}$ MTL) were analyzed at preoperatively and at final follow up visit. Results: VAS improved from $6.8{\pm}1.8$ points to $2.2{\pm}1.8$ points (p<0.05). AOFAS score improved from $54.0{\pm}14.2$ points to $90.0{\pm}4.8$ points (p<0.05). There was no change in shoes selectivity. 9 feet (34.6%) were satisfied with excellent results, 16 feet (61.5%) with good results and 1 foot (3.9%) with fair results. The average 4-5$^{th}$ IMA was corrected from $10.1{\pm}2.3^{\circ}$ to $4.4{\pm}1.7^{\circ}$ (p<0.05). The average 5$^{th}$ MPA was corrected from $11.5{\pm}8.6^{\circ}$ to $-0.1{\pm}4.1^{\circ}$ (p<0.05). The average 5$^{th}$ MTL was changed from $66.1{\pm}4.3$ millimeters to $64.1{\pm}4.4$ millimeters (p=0.069). There was no malunion, nonunion or delayed union and other perioperative complications. Conclusion: S.E.R.I. operation is less invasive and easy technique. This procedure is recommendable for the treatment of the bunionette deformity.

Keywords

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