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Endolog technique for correction of hallux valgus: a prospective study of 30 patients with 4-year follow-up.

Biz C, Corradin M, Petretta I, Aldegheri R - J Orthop Surg Res (2015)

Bottom Line: The postoperative radiographic assessments showed a statistically significant improvement compared with preoperative values.The mean corrections for each angular value at the last follow-up were as follows: IMA 5.95°; HVA 16.81°; DMAA 10.70°; and tibial sesamoid 1.36°.The Endolog is a safe and effective technique for the correction of HV deformity, to relieve pain and to preserve joint movement.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, via Giustiniani 2, 35128, Padova, Italy. carlo.biz@unipd.it.

ABSTRACT

Background: Hallux valgus (HV) is a complex deformity of the forefoot altering the kinematics of walking. Many different treatment alternatives exist for the correction of hallux valgus, but to date, none has been shown to be more effective than any other. The rate of complications following hallux valgus surgery is variable and has been reported as ranging from 1 to 55 % in the scientific literature. The purpose of this preliminary prospective study was to evaluate the result of the Endolog device, an innovative titanium endomedullary nail, for the treatment of HV.

Methods: Thirty patients with mild-to-severe HV were treated with the Endolog device. Clinical evaluation was assessed preoperatively, as well as at 3, 6, 12, 24, and 48 months after surgery with a final follow-up at 4 years, using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux grading system. Computer-assisted measurement of weight-bearing antero-posterior radiographs was taken preoperatively and postoperatively, as well as at 3, 6, 12, 24, and 48 months after surgery. Non-weight-bearing radiographs were taken before the patients were discharged. The radiological parameters measured included the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA), and the tibial sesamoid position. Statistical analysis was carried out using the paired t test (p < 0.05).

Results: The mean AOFAS score was 93.98 points at the 48-month follow-up. The postoperative radiographic assessments showed a statistically significant improvement compared with preoperative values. The mean corrections for each angular value at the last follow-up were as follows: IMA 5.95°; HVA 16.81°; DMAA 10.70°; and tibial sesamoid 1.36°.

Conclusion: The Endolog is a safe and effective technique for the correction of HV deformity, to relieve pain and to preserve joint movement.

No MeSH data available.


Related in: MedlinePlus

The complete kit of the Endolog device
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Related In: Results  -  Collection

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Fig1: The complete kit of the Endolog device

Mentions: The Endolog, produced since 2006 by Medical2, Castelnuovo del Garda, Verona, Italy, is a curved titanium endomedullary nail device (TA6V ELI - ASTMF 136), treated with anodic oxidation and laser marking. It is formed by a curvilinear cylindrical body with a diameter of 4.5 mm and a blade inclined by 4° with respect to the axis of the nail, which serves to push for lateral translation of the metatarsal head. The Endolog is available in three sizes (44, 45, and 46) with three different degrees of curvature (32°, 40°, and 42°) and three different lengths (26, 31, and 33 mm). It is fixed to the metatarsal head using a 3.66-mm titanium angular stable screw, available in three different lengths (15, 20, and 25 mm), which stabilizes the osteotomy sides and the translation of the metatarsal head (Fig. 1). The term Endolog was coined by its inventor Giuseppe Lodola with reference to the endomedullary component of the nail (Endo) and his own initials (Lo-G). It is provided with dedicated instruments that include an impactor with a special drill guide, three test sizes of the nail, a graduated drill tip, and a screwdriver. These features give the device maximum biocompatibility, no interference in case of MR scan investigation, absolute sterility, traceability of the system, and adherence to the European legal regulations (93/42CE). As far as we are aware, no other available device has the unique technical characteristics of this nail, apart from the predecessor of the Endolog, the “hallux splint” [10].Fig. 1


Endolog technique for correction of hallux valgus: a prospective study of 30 patients with 4-year follow-up.

Biz C, Corradin M, Petretta I, Aldegheri R - J Orthop Surg Res (2015)

The complete kit of the Endolog device
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4492074&req=5

Fig1: The complete kit of the Endolog device
Mentions: The Endolog, produced since 2006 by Medical2, Castelnuovo del Garda, Verona, Italy, is a curved titanium endomedullary nail device (TA6V ELI - ASTMF 136), treated with anodic oxidation and laser marking. It is formed by a curvilinear cylindrical body with a diameter of 4.5 mm and a blade inclined by 4° with respect to the axis of the nail, which serves to push for lateral translation of the metatarsal head. The Endolog is available in three sizes (44, 45, and 46) with three different degrees of curvature (32°, 40°, and 42°) and three different lengths (26, 31, and 33 mm). It is fixed to the metatarsal head using a 3.66-mm titanium angular stable screw, available in three different lengths (15, 20, and 25 mm), which stabilizes the osteotomy sides and the translation of the metatarsal head (Fig. 1). The term Endolog was coined by its inventor Giuseppe Lodola with reference to the endomedullary component of the nail (Endo) and his own initials (Lo-G). It is provided with dedicated instruments that include an impactor with a special drill guide, three test sizes of the nail, a graduated drill tip, and a screwdriver. These features give the device maximum biocompatibility, no interference in case of MR scan investigation, absolute sterility, traceability of the system, and adherence to the European legal regulations (93/42CE). As far as we are aware, no other available device has the unique technical characteristics of this nail, apart from the predecessor of the Endolog, the “hallux splint” [10].Fig. 1

Bottom Line: The postoperative radiographic assessments showed a statistically significant improvement compared with preoperative values.The mean corrections for each angular value at the last follow-up were as follows: IMA 5.95°; HVA 16.81°; DMAA 10.70°; and tibial sesamoid 1.36°.The Endolog is a safe and effective technique for the correction of HV deformity, to relieve pain and to preserve joint movement.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, via Giustiniani 2, 35128, Padova, Italy. carlo.biz@unipd.it.

ABSTRACT

Background: Hallux valgus (HV) is a complex deformity of the forefoot altering the kinematics of walking. Many different treatment alternatives exist for the correction of hallux valgus, but to date, none has been shown to be more effective than any other. The rate of complications following hallux valgus surgery is variable and has been reported as ranging from 1 to 55 % in the scientific literature. The purpose of this preliminary prospective study was to evaluate the result of the Endolog device, an innovative titanium endomedullary nail, for the treatment of HV.

Methods: Thirty patients with mild-to-severe HV were treated with the Endolog device. Clinical evaluation was assessed preoperatively, as well as at 3, 6, 12, 24, and 48 months after surgery with a final follow-up at 4 years, using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux grading system. Computer-assisted measurement of weight-bearing antero-posterior radiographs was taken preoperatively and postoperatively, as well as at 3, 6, 12, 24, and 48 months after surgery. Non-weight-bearing radiographs were taken before the patients were discharged. The radiological parameters measured included the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA), and the tibial sesamoid position. Statistical analysis was carried out using the paired t test (p < 0.05).

Results: The mean AOFAS score was 93.98 points at the 48-month follow-up. The postoperative radiographic assessments showed a statistically significant improvement compared with preoperative values. The mean corrections for each angular value at the last follow-up were as follows: IMA 5.95°; HVA 16.81°; DMAA 10.70°; and tibial sesamoid 1.36°.

Conclusion: The Endolog is a safe and effective technique for the correction of HV deformity, to relieve pain and to preserve joint movement.

No MeSH data available.


Related in: MedlinePlus