Comparing the Temperature Effect of Dedicated Minimally Invasive Motor System to the Discontinuous Use of Rotatory Burrs in the Correction of Hallux Valgus

Abstract

The purpose of this study was to compare 2 motor systems for percutaneous osteotomy. The study consisted of 2 stages. In the first stage, bone temperatures during osteotomy using burrs or saw was measured using a thermal camera. In the second stage, the tissue and burr temperature elevation during surgery in 80 consecutive patients (96 feet) with hallux valgus undergoing distal first metatarsal and phalangeal osteotomies (hallux and in 61/96 feet lesser digits) were measured. The burr osteotomy procedure included the use of irrigated 2- or 4.1 mm rotary wedge burrs in discontinuous cutting bursts of less than 20 seconds. Tissue surface temperature was measured with a thermal camera. The temperature generated during the procedure was found to be significantly associated with the burr diameter used but was not affected by the type of motor. At the 6-week visit, thickness of the soft tissues over the first metatarsal head was similar in both groups. Temperature control using a noninvasive thermal camera is recommended to prevent tissue damage associated with heat generated during the use of rotary burrs. A dedicated low-speed high-torque system does not seem to be necessary and standard orthopaedic equipment can be used.

Levels of Evidence: Level II: Comparative prospectively collected series