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The FAST Percutaneous Chevron Technique

Published in N°274 - May 2018
Article viewed 170 times

The FAST Percutaneous Chevron Technique

By Frédéric Leiber-Wackenheim (1), Michael Andrieu (2) in category TECHNIQUE
(1) Clinique de l’Orangerie - Strasbourg / (2) Clinique du Pont de Chaume - Montauban

Fixed percutaneous chevron osteotomy is a recent surgical technique for hallux valgus that has been described by several authors throughout the world using different terminology.
There are a few differences between published osteotomy techniques; however, all of the proposed fixation methods are technically challenging and expose the surgical team to numerous fluoroscopic checks.

Introduction

Fixed percutaneous chevron osteotomy is a recent surgical technique for hallux valgus that has been described by several authors throughout the world using different terminology.

There are a few differences between published osteotomy techniques; however, all of the proposed fixation methods are technically challenging and expose the surgical team to numerous fluoroscopic checks.

The FAST technique (Fast And Secure Translation) was developed to enable fast and secure chevron fixation.


Surgical technique

The technique is divided into 9 surgical steps. To reduce the number of skin incisions, the approach routes are used several times during the procedure. Exostosectomy, sesamoidal release, and osteotomy of the first phalanx (P1) are optional stages that may be performed depending on each surgeon’s practice. Mandatory fluoroscopic checks will be indicated at each step; however, their number should be higher at the beginning of the learning curve.

Step 1: Exostosectomy

This is an optional step as it is thought to cause postoperative stiffness and should thus be performed only when necessary.

Incision 1 (Fig. 1) is made in the axis of the first metatarsal (M1) halfway up its head, 0.5 cm behind the joint line. This incision will be used at a later stage to place the...

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