Impact of using an original guiding device on operative time and radiation exposure in minimally invasive <i>Hallux Valgus</i> correction

Background. Minimally invasive Chevron and Akin osteotomy (MICA) for hallux valgus is a high-tech procedure, with certain stages potentially being time-consuming and requiring intraoperative fluoroscopic guidance. The aim of the study – to evaluate the impact of the original guide device on the operative time, fluoroscopy time, and radiation exposure during minimally invasive Chevron and Akin osteotomy of the first metatarsal bone. Methods. The study included 42 patients with hallux valgus, divided into two groups. All patients underwent surgery using a minimally invasive technique. The Guiding Device Group consisted of 21 patients who underwent osteotomy with the use of the original guide. The Freehand Group included 21 patients who underwent osteotomy without the guide. At the end of the procedure, the duration of the surgery and the radiation dose – measured using the image intensifier sensors – were recorded. Results. The median duration of surgery in the Guiding Device Group was 25.00 minutes [25.00; 30.00], while in the Freehand Group it was 45.00 minutes [40.00; 57.50]. The observed differences were statistically significant (p 0.001). The mean radiation dose was 0.30±0.06mGy in the group where the guide was used, and 0.79±0.20mGy in the group where guidewires for screws were inserted freehand. The mean difference between the groups for this parameter was 0.49mGy (95% CI 0.39-0.58mGy; p 0.001). Pain intensity assessed by the VAS at 2, 4, and 8 weeks, and at 6 months postoperatively, was lower in patients who underwent surgery with the guide (p 0.05 for all time points). Conclusion. The use of the original guiding device in minimally invasive corrective osteotomies for hallux valgus deformity significantly reduced operative time and radiation exposure for both the patient and the surgeon.