Percutaneous forefoot surgery in 2025
Seance of wednesday 22 october 2025 (L'Académie reçoit l'Association Française de la Chirurgie du Pied (AFCP))
DOI number : 10.26299/5a8v-xs34/emem.2025.43.05
Abstract
Percutaneous foot surgery has been advancing in France since the 2000s, driven by the study and research group on minimally invasive foot surgery (GRECMIP), which has since evolved into the Minimally Invasive Foot and Ankle Society (MIFAS).
Over the past 25 years, this technique has undergone substantial development. Today, numerous scientific publications provide validation for its applications. This presentation aims to demonstrate the primary applications of percutaneous foot surgery and their outcomes.
The results of percutaneous hallux valgus surgery exemplify this evolution. Prospective studies conducted on second, third, and fourth-generation fixed techniques for moderate to severe deformities yield outcomes comparable to open techniques in terms of angle improvement, quality of life enhancement, and complication reduction. Additionally, in certain cases, postoperative dorsal flexion is improved.
The treatment of non-dislocated central metatarsalgia using distal metatarsal osteotomies (DMMO) has demonstrated favorable outcomes in limited indications. Recent publications highlight advancements in these osteotomies, expanding their scope to include the treatment of isolated metatarsalgia, metatarsophalangeal instabilities, and even certain dislocations.
Bunionettes can be treated percutaneously with positive results, as evidenced by published retrospective studies.
A novel classification of lateral toe deformities has facilitated the systematic management of reducible deformities, combining osteotomies, tenotomies, and occasionally condylectomy in sequence and on demand. The management of rigid deformities by arthrodesis with screw fixation achieves similar outcomes to open surgery, employing a less invasive approach.
In conclusion, significant progress has been made in the validation of percutaneous techniques, and the potential for further advancement remains substantial.
Over the past 25 years, this technique has undergone substantial development. Today, numerous scientific publications provide validation for its applications. This presentation aims to demonstrate the primary applications of percutaneous foot surgery and their outcomes.
The results of percutaneous hallux valgus surgery exemplify this evolution. Prospective studies conducted on second, third, and fourth-generation fixed techniques for moderate to severe deformities yield outcomes comparable to open techniques in terms of angle improvement, quality of life enhancement, and complication reduction. Additionally, in certain cases, postoperative dorsal flexion is improved.
The treatment of non-dislocated central metatarsalgia using distal metatarsal osteotomies (DMMO) has demonstrated favorable outcomes in limited indications. Recent publications highlight advancements in these osteotomies, expanding their scope to include the treatment of isolated metatarsalgia, metatarsophalangeal instabilities, and even certain dislocations.
Bunionettes can be treated percutaneously with positive results, as evidenced by published retrospective studies.
A novel classification of lateral toe deformities has facilitated the systematic management of reducible deformities, combining osteotomies, tenotomies, and occasionally condylectomy in sequence and on demand. The management of rigid deformities by arthrodesis with screw fixation achieves similar outcomes to open surgery, employing a less invasive approach.
In conclusion, significant progress has been made in the validation of percutaneous techniques, and the potential for further advancement remains substantial.