Application of an Interosseous Suture and Button Device for Hallux Valgus Correction: A Review of Outcomes in a Small Series

Abstract 

A relatively new method to treat a bunion deformity by means of positional correction rather than structural realignment via osteotomy has been used in a series of 5 patients. This approach to first ray correction entails the use of an interosseous suture and button device that is positioned under tension between the first and second metatarsals, thereby reducing the first intermetatarsal angle. The median age of the group of patients was 51 years (range, 16-71 years), and the median follow-up duration was 20 months (range, 8-64 months). Statistically significant reductions in the first intermetatarsal and hallux abductus angles were observed between the preoperative and immediate postoperative measurements (P = .0006 and P = .0044, respectively) and between the preoperative and long-term postoperative measurements (P = .0189 and P = .0305, respectively), and, although loss of correction was observed between the immediate and long-term postoperative first intermetatarsal and hallux abductus angles, these changes were not statistically significant (P = .1369 and P = .1193, respectively). In 3 (60%) of the cases, complications developed that required revisional surgery and removal of the device. In the other 2 (40%) cases, the surgical procedure was modified and satisfactory outcomes were obtained, although minor complications occurred in both. Based on our experience with these patients, the modified surgical procedure shows some effectiveness in treating hallux abductovalgus, although further evaluation of the technique is warranted.

Level of Clinical Evidence: 4

Keywords: Arthrex Mini TightRope, bunion, intermetatarsal angle, hallux abductus angle, stress fracture