The Endolog technique for moderate to severe hallux valgus treatment: Clinical and radiographic analysis of 194 patients.

BACKGROUND: Endolog is an intra-medullary titanium device used for a minimally-invasive hallux valgus correction. The aim of this study was to evaluate clinical and radiographic outcomes of this device. METHODS: A retrospective study with a prospective data collection was conducted. Patients underwent to Endolog procedures from September 2009 to April 2017 were enrolled. Mild HV deformity (HVA ≤ 19° and IMA ≤ 13°) or associated procedure to Endolog technique were excluded. The radiological (HVA, IMA and PASA) and clinical (AOFAS score) pre and post-operative data were compared through Wilcoxon Signed-Rank test. RESULTS: 194 feet (144 moderate and 50 severe HV) underwent HV correction respecting study's criteria. AOFAS scores significantly improved from 31.0 ± 12.7 points preoperatively to 88.5 ± 8.0 at 24 months. Even all radiographic measurements significantly improved during 2 years' follow-up. Only 6 patients experienced complications: 4 cases of HV recurrence and 2 cases of intolerance device-related pain. CONCLUSIONS: Endolog technique proved to be a valid option in the moderate-to-severe hallux valgus treatment, comparable to other surgical techniques described in literature.

Minimally invasive reduction of vertically displaced sacral fracture without use of traction table.

BACKGROUND: Treatment of vertically displaced sacral fracture can be difficult even for the expert traumatologist. Traditional reduction methods can show some limitations; we suggest a minimally invasive technique, which could be effective, tissue sparing and economic in terms of equipment needed. MATERIALS AND METHODS: Our retrospective study included 11 patients with average age of 40.2 years (range 24-59 years), with type C pelvic ring disruption with monolateral sacral fracture (C1.3), who underwent surgical treatment from April 2007 to March 2008 using the minimally invasive technique. Radiographic examination, using Matta's criteria, was carried out pre-operatively, post-operatively and at least at 1 year after surgery. All patients were functionally evaluated using Majeed's grading scale with mean follow-up time of 18.9 months (range 14-25 months). RESULTS: Pre-operative displacements averaged 10.8 mm (range 7-21 mm); post-operative displacements averaged 5.4 mm (range 3-12 mm), with excellent or good reduction in 91% of cases. No major complications occurred. On functional evaluation, 82% of patients obtained good or excellent results. CONCLUSION: The minimally invasive reduction technique, requiring a limited surgical approach and a standard radiolucent table, is in our experience a satisfactory procedure for management of monolateral vertically displaced sacral fracture.