Trial reportJournal of orthopaedic surgery and research2025
Multimodal evaluation of partial zig-zag tenotomy of the extensor hallucis longus in minimally invasive hallux valgus surgery: a randomized trial.
Trial report in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06243471 ("Hallux Abductus Valgus and Extensor Hallux Longus), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
"Hallux Abductus Valgus and Extensor Hallux Longus: Relationship Between Them, Preoperative and Postoperative Assessment, Pressure Platform and Treatment by MIS Surgery"
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0 citing papers in PubMed.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHallux abductus valgus (HAV) is a common, complex forefoot deformity with significant clinical and functional implications. While minimally invasive surgery (MIS) often results in better recovery and improved cosmetic outcomes, adjunctive procedures such as zig-zag tenotomy of the extensor hallucis longus (EHL) tendon remain poorly documented. This study aims to evaluate the clinical, structural, and functional outcomes of MIS with and without EHL tenotomy in patients with moderate to severe HAV.
methodsThis was a prospective, randomized, controlled, single-blind clinical trial conducted in a private clinic in Alicante, Spain, between February 2024 and June 2025. Adults aged 20-90 years with moderate/severe HAV and hallux hyperextension were randomized (ABBA sequence, concealed by independent investigator) to MIS with zig-zag EHL tenotomy (n = 25) or MIS without tenotomy (n = 21). Both groups underwent Reverdin-Isham and Akin osteotomies plus adductor tenotomy. PRIMARY OUTCOME: change in the hallux valgus angle (HVA) at 12 months. SECONDARY OUTCOMES: changes in PASA, IMA, DASA, MPA, IPA, mean and peak plantar pressure (static baropodometry, S-Plate®), and AOFAS score. Intra- and intergroup differences were analyzed using t-tests and repeated-measures ANOVA, reporting p-values and effect sizes (Cohen's d, 95% CI).
resultsOf 49 patients assessed, 46 were randomized (4 men, 42 women; mean age 62.0 ± 13.6 years). At 12 months, both groups improved significantly in HVA: tenotomy group - 18.2° (95% CI - 21.9 to - 14.5; d = 1.73; p < 0.001) vs. no-tenotomy - 16.9° (95% CI - 21.5 to - 12.3; d = 1.83; p < 0.001), with no significant between-group difference. The tenotomy group showed greater reductions in PASA (- 5.68°, d = 1.12), IMA (- 4.16°, d = 1.30), and IPA (- 12.17°, d = 1.20). Mean plantar pressure increased significantly only in the tenotomy group (+ 18.7 g/cm
conclusionsIn moderate/severe HAV, adding zig-zag EHL tenotomy to MIS may provide additional benefits in radiographic correction and plantar load redistribution without impairing functional recovery. These findings support its use in complex deformities or high tendon tension, though longer-term follow-up is needed to assess stability and recurrence.
trial registrationClinicalTrials.gov ID NCT06243471 (Feb 2024).
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