The Minimally Invasive Osteotomy “S.E.R.I.” (Simple, Effective, Rapid, Inexpensive) for Correction of Bunionette Deformity

Abstract

Background: A bunionette is a deformity of the fifth metatarsal bone with a varus deviation of the toe which can require surgical correction. Although numerous bony or soft tissue surgical procedures have been described, the ideal treatment has not yet been identified. The aim of this study was to retrospectively evaluate the results of a series of 50 consecutive feet affected by symptomatic bunionette deformity treated by S.E.R.I. (simple, effective, rapid, inexpensive) osteotomy. Materials and Methods: Between February 1998 and March 2004, 50 feet with symptomatic type II-III bunionette deformity in 32 patients (18 bilateral) underwent S.E.R.I osteotomy. The average age of the patients at the time of operation was 33 ± 13 years. The average followup was 4.8 (range, 2 to 8) years. Results: The average modified lesser toe AOFAS score increased from 62.8 ± 15.2 points preoperatively to 94 ± 6.8 points at last followup ( p < 0.0005). The average fifth metatarsophalangeal (MTP) angle decreased from 16.8 ± 5.1 degrees preoperatively to 7.9 ± 3.1 degrees at final followup ( p < 0.0005). The 4–5 intermetatarsal angle (I.M.A) averaged 12 ± 1.7 degrees preoperatively, while postoperatively was 6.7 ± 1.7 degrees ( p < 0.0005). Complications included a skin inflammatory reaction around the Kirschner wire and 2 symptomatic plantar callosities under the fourth metatarsal heads. Conclusions: The minimally invasive osteotomy is an effective and reliable technique for the treatment of painful bunionette, and it achieved more than 90% excellent and good results with reduced surgical time and complications.