Early Radiographic Outcomes of Minimally Invasive Distal Metatarsal Osteotomies with the Spear Plate in Asian Patients for Hallux Valgus Correction

RESEARCHintramedullary plate to stabilize transverse osteotomies of the distal first metatarsal for the correction of hallux valgus deformity.Based on our knowledge, this is the first study on the use of this Spear plate implant. Materials a n d MethodsPatients who had undergone minimally invasive first metatarsal distal transverse osteotomy with Spear plate stabilization between June 2020 and February 2022 were identified and recruited in our retrospective study.All procedures were performed by a single introduction Surgery can be offered to patients with hallux valgus deformities if conservative measures have failed to relieve their symptoms.Numerous surgical techniques have been reported for the correction of this deformity. 1Traditional open procedures such as the scarf osteotomy have been reported to have high patient satisfaction outcomes as well as satisfactory radiological correction. 2 The optimal surgical procedure, however, has yet to be elucidated.Bosch showed good results with a percutaneous distal metatarsal transverse osteotomy stabilized by an axial wire. 3Magnan et al. also showed similarly good results with the same procedure. 4However, Huang et al. reported a loss of correction when the Kirchner wire, used to stabilize the osteotomy site, was removed. 5This is of particular concern as Kirschner wires may be insufficient to give stability to these inherently unstable osteotomies.Screws instead of wires were subsequently used.][8][9] The Spear plate system (Aplus Biotechnology) had been designed for the Asian anatomy.The curved Spear plate, with different offset options and locking screw purchases in the two ends of the osteotomy, is placed in the intramedullary canal of the first metatarsal for stabilization.This can be done through a small skin incision in a minimally invasive fashion.However, there is no study on the use of an intramedullary plate that is designed for Asian patients.In this article, we study the early radiological outcomes of using the Spear plate as an