Changes in Foot Width in Minimally Invasive Bunionectomy

Category: Bunion; Midfoot/Forefoot Introduction/Purpose: Hallux Valgus (HV) is a common foot condition often requiring surgical intervention. Minimally invasive bunionectomy (MISB) has gained popularity for HV correction. While previous research has focused on distal foot width changes following surgery, this study introduces a novel midshaft measurement to assess proximal transverse midfoot width. The study aims to provide a comprehensive evaluation of foot width changes post-MISB. Methods: A retrospective review of prospectively collected data was conducted for 44 patients who underwent MISB for HV via an institutional outcome registry. Demographic data, surgical details, radiographs, and foot width measurements were collected. Changes in hallux valgus angle (HVA) and intermetatarsal angle (IMA) were also measured. The novel midshaft bony and soft tissue foot width measurements were included. Two independent observers conducted all preoperative and postoperative measurements. Results: Intraclass correlation coefficients (ICCs) demonstrated high interobserver reliability (all ICCs >0.70) for all measurements. MISB resulted in a consistent reduction in distal foot width, both bony (8.17%) and soft tissue (5.24%)(p < 0.001). These reductions correlated with changes in HVA and IMA, suggesting the extent of deformity correction influenced distal foot width (all r > 0.375, p < 0.05). However, the study revealed that proximal foot width, as measured by midshaft bony width, increased (5.27%) in the majority of cases (p < 0.001). Changes in midshaft foot width showed no correlation with HVA or IMA alterations. Conclusion: MISB for HV leads to an increase in midshaft foot width due to the unique mechanics of the procedure. Simultaneously, there is a decrease in distal foot width, which correlates with the extent of deformity correction. This results in a more uniform foot width. These findings may influence patient satisfaction, comfort, and shoe wear capabilities post-surgery. Further research should assess patient perception and comfort regarding these foot width changes after MISB.