Minimally Invasive Tailor's Bunion Correction: Radiographic and Functional Outcomes With and Without Screw Fixation.

Abstract

Minimally invasive techniques for tailor's bunion correction have gained popularity; however, the influence of screw fixation on radiographic correction, functional outcomes, and complication profile remains unclear. The purpose of this study was to evaluate radiographic and patient-reported outcomes following minimally invasive distal fifth metatarsal osteotomy and to assess the effect of screw fixation. Retrospective cohort study. A retrospective cohort study was performed including 68 feet undergoing minimally invasive fifth metatarsal osteotomy. Radiographic outcomes were assessed using weightbearing fourth-fifth intermetatarsal angle (IMA) measurements at the foot level. Functional outcomes were evaluated using the Foot Function Index (FFI) in 31 patients. Secondary analyses compared screw (n = 32 feet) and non-fixation (n = 36 feet) cohorts. Effect sizes were calculated using Cohen's d. Mean preoperative IMA improved from 10.0° ± 2.8° to 4.0° ± 2.7° (p < 0.001; d = 2.93). Mean FFI improved from 94.8 ± 57.8 to 39.6 ± 33.3 (p < 0.001; d = 0.88). Fixation achieved greater angular correction (6.8° ± 2.2° vs 5.3° ± 1.7°, p = 0.003) but similar final IMA (p = 0.66) and functional improvement (p = 0.17). No nonunions occurred in the fixation group, whereas two nonunions (5.6%) occurred without fixation (p = 0.49). Hardware irritation occurred in 37.5% of fixation cases, with 15.6% requiring removal. Minimally invasive tailor's bunion correction provides significant radiographic and functional improvement. Screw fixation influences complication profile rather than final alignment or functional outcome. III.