Evaluation of proximal foot width after fourth generation minimally invasive surgery for hallux valgus

Background: Hallux valgus is a common foot deformity that significantly impacts functionality and causes pain. Minimally invasive surgical techniques, such as the Chevron-Akin procedure, have been developed to correct this deformity. This study evaluates the efficacy of the fourth-generation Minimally Invasive Chevron-Akin (MICA) technique in correcting proximal foot width. Objective: We aimed to compare proximal and forefoot foot width (bony and soft tissues) in radiological images pre-vs. post-corrective MICA osteotomy in patients with hallux valgus. Methods: A retrospective comparative study was conducted on 81 patients (132 feet) who underwent MICA surgery for symptomatic hallux valgus. Radiographic measurements of bony and soft tissue widths were taken pre-and postoperatively. Statistical analyses included t-tests, Wilcoxon tests, and Pearson correlation coefficients. Results: postoperatively significant reductions in both forefoot and proximal foot widths were observed. Bony foot width decreased from 83.02 mm to 77.35 mm, and soft tissue foot width decreased from 101.66 mm to 95.23 mm. Proximal bony width reduced from 68.79 mm to 65.82 mm, and proximal soft tissue width from 87.46 mm to 85.92 mm. These changes were significantly correlated with improvements in angular parameters (HVA, IMA, DMAA). Conclusion: The fourth-generation MICA technique effectively reduces both forefoot and proximal foot widths, contributing to high patient satisfaction and optimal surgical outcomes.