Comparison of outcomes between proximal and distal chevron osteotomy, both with supplementary lateral soft-tissue release, for severe hallux valgus deformity: A prospective randomised controlled trial

Background. The study was done to evaluate short term clinico-radiological results of distal chevron osteotomy without lateral soft tissue release in mild to moderate hallux valgus. Materials and methods. This was a prospective study consisting of a total of 35 cases with mild to moderate hallux valgus deformity. All these patients were treated by distal chevron osteotomy without lateral soft tissue release. Results. In our study, the average value of hallux angle preoperatively was 32° (range, 24°-40°) and at final follow-up it was 14° (range, 8°-31°). The average reduction was 18°. The average intermetatarsal angle showed mean reduction of 5.3° at the final follow-up. Average range of motion of the first metatarsophalyngeal joint preoperatively and at final follow-up showed a small reduction of 5 degrees. The average preoperative AOFAS score was 49, which improved by 35 points to 84 at the final follow-up. 11.42% of the patients in the study group had a recurrence. Conclusions. 1. Based on our experience with distal chevron osteotomy without lateral soft tissue release, we found the procedure easy to perform with good procedural outcomes. 2. The possible complications of lateral soft tissue release are avoided.

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Clinical Outcomes after Chevron Procedure are Better than Pedobarographic Results

Key Engineering Materials ◽

10.4028/www.scientific.net/kem.601.177 ◽

2014 ◽

Vol 601 ◽

pp. 177-180

Author(s):

Radu Prejbeanu ◽

Dinu Vermesan ◽

Horia Hărăgus ◽

Simona Vermesan ◽

Dan Ioan Stoia

Keyword(s):

Clinical Outcomes ◽

Hallux Valgus ◽

Pressure Sensors ◽

Valgus Deformity ◽

Physical Contact ◽

Chevron Osteotomy ◽

Hallux Valgus Deformity ◽

Reaction Forces ◽

Severe Hallux Valgus ◽

Better Than

The distal Chevron or Austin procedure, is arguably the most prominent of the distal metatarsal osteotomies. Recent studies in the literature have shown a trend in recommending this osteotomy or one if it’s modifications for even severe hallux valgus deformities. Therefore we aimed to compare the clinical and pedobarographic results after chevron osteotomy in patients with moderate hallux valgus deformity. We investigated a homogeneous lot of 10 patients undergoing hallux valgus correction using distal chevron technique. In order to quantify the improvement of the gait in these patients, several biomechanical parameters have been measured using a matrix of pressure sensors that provide us the vertical reaction forces when the foot is in physical contact with it. Results show an improvement in patient’s velocity and cadence after the surgery, and also a smaller variability in gait. Nevertheless, optimal clinical outcomes are still found to have altered ground reaction forces on pedobarographic assessment.

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Importance of postoperative sesamoid reduction on the outcomes of proximal chevron osteotomy for moderate to severe hallux valgus deformity

Foot and Ankle Surgery ◽

10.1016/j.fas.2018.02.006 ◽

2019 ◽

Vol 25 (4) ◽

pp. 434-440 ◽

Cited By ~ 1

Author(s):

Keun-Bae Lee ◽

Myung-Sun Kim ◽

Kyung-Soon Park ◽

Gun-Woo Lee

Keyword(s):

Hallux Valgus ◽

Valgus Deformity ◽

Chevron Osteotomy ◽

Hallux Valgus Deformity ◽

Severe Hallux Valgus

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Rotated Insertion Metatarsal Osteotomy with Distal Soft Tissue Procedure for Severe Hallux Valgus Deformity ―Novel Procedure of the 1st metatarsal osteotomy―

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000348 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0003

Author(s):

Norihiro Samoto ◽

Yasuhito Tanaka ◽

Ryuhei Katsui ◽

Kazuya Sugimoto

Keyword(s):

Soft Tissue ◽

Hallux Valgus ◽

Locking Plate ◽

Valgus Deformity ◽

Metatarsal Osteotomy ◽

Rigid Fixation ◽

Soft Tissue Procedure ◽

Hallux Valgus Deformity ◽

The Mean ◽

Severe Hallux Valgus

Category: Bunion Introduction/Purpose: Hallux valgus deformity is recently a common disease involved in the foot and ankle and many procedures are recommended globally. However it is controversial about the operative treatment for severe hallux valgus. Many authors have reported the technical difficulties and various complications. We performed rotated insertion metatarsal osteotomy with the distal soft tissue procedure for severe hallux valgus deformity since January 2008. The purpose of this study is to evaluate the medium-term outcome of this procedure. Methods: Two hundred thirty-two feet in 173 patients were enrolled in this study and followed them up for a mean of 44.5 months. The mean age at the operation was 64.5 years. Hallux valgus angle(HVA) and intermetatarsal angle(IMA) were measured. This procedure consists of the rotated insertion metatarsal osteotomy and the distal soft tissue procedure. This diaphysial longitudinal metatarsal oblique osteotomy was performed from proximally- medial site of the first metatarsal directed to distally- lateral site through the dorsal exposure. The tip of osteotomized proximal metatarsal was formed at the dorso-distal site to insert in the central intramedullary aspect of osteotomized distal metatarsal. The second triangular cut of one third of dorso-plantar thick was made about 10 to 15 mm length from the lateral tip of osteomized proximal metatarsal. The internal fixation was performed with locking plate with screws. As a result, osteotomized sites were locked each other such as a puzzle. Results: The mean preoperative HVA and IMA were 43.8 degrees and 20.1 degrees. The mean postoperative HVA and IMA were decreased to 9.0 degrees and 6.1 degrees. AOFAS scores improved from 49.3 to 89.7. All cases were obtained complete union. Postoperative displacement was in 12 feet (5.2%) and followed under-correction (or recurrence). Overcorrection (hallux varus) occurred in 10 feet (4.7%). Wound healing was delayed in 21 feet (9.1%). In general, we found no severe complication and unsatisfactory result. Conclusion: This procedure provided satisfactory result for severe hallux valgus deformity. Especially the rigid fixation at the site of metatarsal osteotomy was much stronger because of the insertion and locking plate. However the further more outcomes in detail are essential for longer term follow-up.

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