scholarly journals The effect of a modified chevron osteotomy for hallux valgus patients: A five-year follow-up study

2021 ◽  
Author(s):  
Shiyong Zhang ◽  
Xue Wang ◽  
Tiannan Chen ◽  
Chengwei Wang ◽  
Jie Wang
Keyword(s):  
Hallux Valgus ◽  
Analog Scale ◽  
Aofas Score ◽  
Intermetatarsal Angle ◽  
Follow Up Study ◽  
Chevron Osteotomy ◽  
Vas Scores ◽  
The Mean ◽  
American Orthopaedic

Abstract Purpose This study aimed to detect the effect of a modified chevron osteotomy on hallux valgus (HV) deformity at five-year follow up. Methods Twenty patients with symptomatic HV who underwent modified chevron osteotomy between June 2014 and January 2016 were included in the present study. The follow-up duration was more than five years. Each patient was evaluated preoperatively, six weeks postoperatively and five years postoperatively using the visual analog scale (VAS) pain score, the American Orthopaedic Foot & Ankle Society (AOFAS) score and cosmetic and radiological outcomes. Results The AOFAS score improved from 54.40 (± 4.58) preoperatively to 94.30 (± 2.15) six weeks postoperatively (p < 0.001) and 96.95 (± 1.54) five years postoperatively (p < 0.001). The VAS scores decreased from 6.30 (± 1.17)preoperatively to 0.15 (± 0.37) five years postoperatively (p < 0.001). The mean intermetatarsal angle improved from 16.00° (± 2.20°) preoperatively to 4.15° (± 1.22°) six weeks postoperatively (p < 0.001) and 4.40° (± 1.39°) five years postoperatively (p < 0.001). The mean HV angle also improved, from 32.70° (± 5.34°) preoperatively to 4.80° (± 1.40°) six weeks postoperatively (p < 0.001) and 5.20° (± 1.32°) five years postoperatively (p < 0.001). The cosmetic results were either excellent or good in 19 patients (95%). There was no recurrence in this study during the five postoperative years. Conclusion A modified chevron osteotomy can achieve successful correction of moderate-to-severe HV, with excellent outcomes at five-year follow up.

scholarly journals Treatment of Moderate Hallux Valgus by Percutaneous, Extra-articular Reverse-l Chevron (PERC) Osteotomy

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Julien Lucas ◽  
Olivier Laffenetre
Keyword(s):  
Hallux Valgus ◽  
Proximal Phalanx ◽  
Subjective Rating ◽  
Outpatient Basis ◽  
Range Of Movement ◽  
Aofas Score ◽  
First Metatarsophalangeal Joint ◽  
Chevron Osteotomy ◽  
The Mean

Category: Midfoot/Forefoot Introduction/Purpose: The purpose of this study was to report a single surgeon series of consecutive patients with moderate hallux valgus managed with a Percutaneous Extra-articular Reverse-L Chevron (PERC) osteotomy. Methods: A total of 38 patients underwent 45 PERC procedures. A medial approach is used just proximal to the flare of the metatarsal head. The osteotomy is performed using a burr, the thickness of which is selected according to the planned correction and shortening. A second dorsolateral approach is then performed and the osteotomy is fixed using a self-drilling, self-tapping 3 mm diameter cannulated and headless compression screw. There were 35 women and three men. The mean age of the patients was 48 years (17 to 69). An additional percutaneous Akin osteotomy was performed in 37 feet and percutaneous lateral capsular release was performed in 22 feet. Clinical and radiological assessments included the type of forefoot, range of movement, the American Orthopedic Foot and Ankle (AOFAS) score, a subjective rating and radiological parameters. The mean follow-up was 59.1 months (45.9 to 75.2). No patients were lost to follow-up. Results: The mean AOFAS score increased from 62.5 (30 to 80) pre-operatively to 97.1 (75 to 100) post-operatively. A total of 37 patients (97%) were satisfied. At the last follow up there was a statistically significant decrease in the hallux valgus angle, the intermetatarsal angle and the proximal articular set angle. The range of movement of the first metatarsophalangeal joint improved significantly. There was more improvement in the range of movement in patients who had fixation of the osteotomy of the proximal phalanx. Conclusion: Preliminary results of this percutaneous approach are promising. This technique is reliable and reproducible. The PERC osteotomy procedure is an effective approach for surgical management of moderate hallux valgus which combines the benefits of percutaneous surgery with the versatility of the chevron osteotomy. Its main asset is that it maintains an excellent range of movement; other advantages relate to the procedure being performed on an outpatient basis and the absence of tourniquet use.

scholarly journals PO 18042 - Surgical treatment of moderate and severe hallux valgus

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 4S
Author(s):  
Rafael Ferreira da Silva ◽  
André Donato Baptista ◽  
Kepler Alencar Mendes de Carvalho
Keyword(s):  
Surgical Treatment ◽  
Hallux Valgus ◽  
Surgical Techniques ◽  
Intermetatarsal Angle ◽  
Chevron Osteotomy ◽  
The Mean ◽  
Invasive Techniques ◽  
Severe Hallux Valgus

Introduction: Hallux valgus is a multifactorial disease, and heredity is the main associated factor. Pain and discomfort when using closed-toed shoes occur in many cases, adversely affecting quality of life. Surgical treatment is indicated when pain and disability persist after conservative treatment. Currently, more than 150 surgical techniques are described for hallux valgus correction, with no consensus regarding the best treatment. With the advent of minimally invasive techniques for hallux valgus correction, Vernois developed the percutaneous chevron osteotomy. This technique allows up to 100% lateral translation of the contact area of the osteotomy. Objective: the objective of the present study was to assess the correction of radiographic parameters, clinical improvement and potential complications of the first 30 cases of moderate and severe hallux valgus operated on at our hospital using the percutaneous chevron technique. Methods: A total of 26 patients (30 feet) underwent surgery. The following parameters were measured in the pre- and postoperative periods: the first metatarsophalangeal (MTP) angle, the intermetatarsal angle between the 1st and 2nd metatarsals (IMA), the distal metatarsal articular angle (DMAA) and the pre- and postoperative American Orthopedic Foot and Ankle Society (AOFAS) scores, with a minimum follow-up period of 6 months. Results: The mean age of the patients was 52.3 years. During the preoperative period, the mean AOFAS score was 45.6; it increased to 90.3 after the procedure, indicating a statistically significant improvement. The mean MTP angle, IMA and DMAA were 29.7°, 14.2° and 14.2° before surgery and 12.8°, 8.2° and 11.1° after surgery, respectively. The improvements in the MTP angle and the IMA were also significant. There was no decrease in angles or worsening of AOFAS scores during follow-up. Conclusion: The percutaneous chevron technique was safe and effective for correcting cases of moderate and severe hallux valgus, with significant improvements in clinical and radiological parameters and a low rate of postoperative complications.

Biplanar Chevron Osteotomy

1998 ◽  
Vol 19 (9) ◽  
pp. 579-584 ◽  
Author(s):  
Loretta B. Chou ◽  
Roger A. Mann ◽  
Mark M. Casillas
Keyword(s):  
Hallux Valgus ◽  
Foot And Ankle ◽  
Hallux Valgus Angle ◽  
Rating Score ◽  
Intermetatarsal Angle ◽  
Clinical Rating ◽  
Chevron Osteotomy ◽  
Valgus Angle ◽  
American Orthopaedic

We retrospectively reviewed the results of using a biplanar chevron osteotomy performed on patients who presented with hallux valgus deformities with an increased distal metatarsal articular angle (DMAA). The study included 17 feet (14 patients) of 12 women and 2 men. The average follow-up was 33 months. The average American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-lnterphalangeal Clinical Rating Score was 91. Ten of the 14 patients (13 of 17 feet) stated that they would choose to undergo the procedure again. The hallux valgus angle was improved from an average of 22° to 18°, the intermetatarsal angle from 11° to 9°, and the DMAA from 16° to 9°. We have demonstrated this procedure to be useful in the treatment of symptomatic bunion deformities with an increased DMAA.

Proximal Oblique Crescentic Osteotomy in Hallux Valgus

2004 ◽  
Vol 94 (1) ◽  
pp. 43-46 ◽  
Author(s):  
Ozcan Pehlivan ◽  
Ibrahim Akmaz ◽  
Can Solakoglu ◽  
Ahmet Kiral ◽  
Haluk Kaplan
Keyword(s):  
Hallux Valgus ◽  
Osteotomy Site ◽  
Intermetatarsal Angle ◽  
First Metatarsal ◽  
Valgus Angle ◽  
Before And After ◽  
The Mean ◽  
American Orthopaedic ◽  
Severe Hallux Valgus

Twenty-six patients with moderate-to-severe hallux valgus deformities were evaluated before and after treatment. All of the patients had incongruent great toe joints. The patients underwent modified proximal crescentic osteotomy, which was termed proximal oblique crescentic osteotomy. The results were evaluated at an average follow-up time of 55 weeks. Objective criteria were hallux valgus angle, intermetatarsal angle, shortening of the first metatarsal, and angulation at the osteotomy site. Clinical evaluation was made according to the rating system of the American Orthopaedic Foot and Ankle Society. The mean correction of the hallux valgus and intermetatarsal angles was 22.1° and 9.9°, respectively. Short-term results indicate that proximal oblique crescentic osteotomy is effective in the treatment of hallux valgus; its advantages over other procedures include its technical ease and low rate of complications. (J Am Podiatr Med Assoc 94(1): 43-46, 2004)

scholarly journals TL 18130 - Surgical treatment of hallux valgus using the modified Reverdin-Isham technique

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 86S
Author(s):  
Luiz Carlos Ribeiro Lara ◽  
Fábio Lemos Rodrigues ◽  
Juan Antônio Grajales ◽  
Lucio Carlos Azevedo Torres Filho
Keyword(s):  
Surgical Treatment ◽  
Hallux Valgus ◽  
Aofas Score ◽  
Intermetatarsal Angle ◽  
Valgus Angle ◽  
Angular Correction ◽  
Classical Technique ◽  
Before And After ◽  
The Mean

Objective: The present study was conducted to clinically and radiographically analyze the outcomes of the surgical treatment of mild and moderate hallux valgus using the modified Reverdin-Isham technique. Methods: We retrospectively studied 46 feet of 39 patients with mild and moderate hallux valgus from June 2010 to July 2017. The mean postoperative follow-up was 36 months, and the mean patient age was 53 years. All patients who underwent the modified Reverdin-Isham technique were clinically and radiologically evaluated before and after surgery using the American Orthopedic Foot and Ankle Society (AOFAS) scale, and radiographs were acquired to calculate the hallux valgus angle (HVA), the intermetatarsal angle (IMA) and the distal metatarsal articular angle (DMAA). Results: The AOFAS score increased by a mean of 54 points. Radiologically, the mean HVA decreased by an average of 17.1°, the IMA by 4.2° and the DMAA by 12°. Conclusion: The modified percutaneous Reverdim-Isham technique made it possible to correct mild and moderate hallux valgus deformities with good angular correction and increased stability compared with the classical technique, in addition to providing an increase in the AOFAS score.

scholarly journals Reverdin-Isham technique with and without fixation

2018 ◽  
Vol 12 (3) ◽  
Author(s):  
Aleksei Dickow Sato ◽  
Ronaldo Muramoto Nakato ◽  
Bruno Cerutti Bolsi ◽  
Thiago Pavani Zigovski ◽  
João Luiz Vieira da Silva
Keyword(s):  
Hallux Valgus ◽  
Case Series ◽  
Foot And Ankle ◽  
Aofas Score ◽  
Intermetatarsal Angle ◽  
Significant Difference ◽  
Proposed Modification ◽  
American Orthopaedic ◽  
Additional Fixation

Objective: This study evaluated the radiographic results of the traditional minimally invasive percutaneous Reverdin-Isham surgical technique for hallux valgus treatment using the American Orthopaedic Foot and Ankle Society (AOFAS) score and compared this result with a proposed modification involving additional osteosynthesis with a cannulated screw. Methods: We retrospectively assessed 22 feet across 15 patients with mild to moderate hallux valgus. All patients underwent surgical treatment using the Reverdin-Isham technique. Eleven feet were fixed with 2.4- or 2.7-mm cannulated screws. A single orthopaedic surgeon performed these procedures between January 2014 and June 2016. The metatarsophalangeal (MTP) angle and intermetatarsal angle (IMA) were evaluated using radiographs, and the AOFAS score was applied before surgery and 90 days after. Results: An improvement was found in the parameters evaluated in both groups, with significant differences shown between the pre- and post-procedure follow-up assessment. No significant difference was found between the groups with regard to fixation; however, the scores were slightly higher for the group where osteosynthesis was used. Conclusions: The Reverdin-Isham procedure is effective and safe for correcting mild to moderate hallux valgus and additional fixation presented with promising results, although without significant difference. Additional studies with larger samples and longer follow-up times are needed to define the role that additional screw fixation plays in the overall scope of treatment.Level of Evidence IV; Therapeutic Studies; Case Series.

Comparison of Radiographic and Clinical Results After Extended Distal Chevron Osteotomy With Distal Soft Tissue Release With Moderate Versus Severe Hallux Valgus

2018 ◽  
Vol 40 (3) ◽  
pp. 297-306 ◽  
Author(s):  
Jae Hwang Song ◽  
Chan Kang ◽  
Deuk Soo Hwang ◽  
Gi Soo Lee ◽  
Sang Bum Lee
Keyword(s):  
Hallux Valgus ◽  
Clinical Results ◽  
Soft Tissue Release ◽  
Hallux Valgus Angle ◽  
Intermetatarsal Angle ◽  
Chevron Osteotomy ◽  
Valgus Angle ◽  
The Mean ◽  
Severe Hallux Valgus

Background: We compared the radiographic and clinical outcomes of moderate and severe hallux valgus treated by extended distal chevron osteotomy (EDCO) and distal soft tissue release (DSTR). Methods: We performed a retrospective analysis comparing the utility of EDCO for the treatment of moderate (36 patients, 46 feet) and severe (36 patients, 42 feet) hallux valgus. The radiologic outcomes were evaluated based on the preoperative and 3-year follow-up x-rays. The clinical results were investigated based on the 3-year follow-up Manchester-Oxford Foot Questionnaire (MOXFQ), patient satisfaction, and postoperative complications. Results: The mean postoperative intermetatarsal angle, hallux valgus angle, tibial sesamoid position, and relative metatarsal bone length were significantly different compared with the preoperative values for both the moderate and severe groups ( P < .001). At 3-year follow-up, intergroup differences were observed in the mean postoperative intermetatarsal angle ( P = .001), hallux valgus angle ( P = .003), and tibial sesamoid position ( P = .013); however, mean radiographic results were within the normal range for both groups. There were no intergroup differences for either the first metatarsal bone length ( P = .172) or shortening ( P = .621). No significant difference in MOXFQ ( P = .525) was evident between the groups at 3-year follow-up. In satisfaction analysis, 82.6% of the moderate group reported good to excellent results, as did 81.0% of the severe group ( P = .815). A total of 7 complications were reported in each group ( P = 1.000). Conclusion: The present study showed that midterm mean radiographic results of both moderate and severe hallux valgus treated by EDCO with DSTR were favorable, and those values were within the normal range. Clinical outcomes were comparable between the 2 groups, including overall efficacy. Based on these results, we recommend EDCO with DSTR as an efficient and reliable operative option for both moderate and severe hallux valgus. Level of Evidence: Level III, retrospective comparative study.

scholarly journals PO 18115 - Percutaneous hallux valgus correction using the Reverdin-Isham osteotomy

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 15S
Author(s):  
Fábio Lemos Rodrigues ◽  
Luiz Carlos Ribeiro Lara ◽  
Juan Antonio Grajales ◽  
Lucio Carlos Torres
Keyword(s):  
Hallux Valgus ◽  
Hallux Valgus Angle ◽  
Aofas Score ◽  
Intermetatarsal Angle ◽  
First Metatarsal ◽  
Valgus Angle ◽  
Angle Correction ◽  
Age At Surgery ◽  
The Mean

Objective: To analyze the outcomes of percutaneous hallux valgus correction using the Reverdin-Isham osteotomy through clinical and radiographic studies. Methods: We retrospectively evaluated 43 feet in 38 patients with mild or moderate hallux valgus from June 2009 to July 2018. The mean age at surgery was 59 years; the mean postoperative follow-up time was 79 months. All patients treated with the Reverdin technique modified by Isham were evaluated in the pre- and postoperative periods using the American Association Orthopedic Foot and Ankle Society (AOFAS) score; we radiographically measured the hallux valgus angle (HVA), the intermetatarsal angle (IMA) and the first distal metatarsal articular angle (DMAA). Results: The AOFAS score increased by an average of 55 points. On average, the HVA decreased by 14°, the IMA by 3° and the DMAA by 9°. The mean reduction in the length of the first metatarsal bone was 0.3 cm. Conclusion: This surgical technique was effective for hallux valgus correction, demonstrating good angle correction and a marked increase in the AOFAS score.

Biplanar Chevron Osteotomy

2002 ◽  
Vol 23 (9) ◽  
pp. 792-798 ◽  
Author(s):  
Caio Nery ◽  
Rui Barroco ◽  
Cibele Réssio
Keyword(s):  
Hallux Valgus ◽  
Valgus Deformity ◽  
Average Score ◽  
Intermetatarsal Angle ◽  
Chevron Osteotomy ◽  
Hallux Valgus Deformity ◽  
Valgus Angle ◽  
Radiological Data ◽  
End Of Treatment

Results of biplanar chevron osteotomy performed on patients with mild-to-moderate hallux valgus deformity with an increased distal metatarsal articular angle (DMAA) are shown. The study included clinical data of 32 patients (54 feet) who had completed a 2-year follow-up, and radiological data of these 32 and other 29 patients (50 feet) for a total of 61 patients (104 feet, 53 right and 51 left). There were 59 females and two males with ages varying from 11 to 66 years. According to the AOFAS Hallux Rating, the preoperative average score (50) improved to 90 (average score after the surgery). The hallux valgus angle was improved from an average of 25° to 14°, the first intermetatarsal angle from 12° to 8° and the DMAA from 15° to 5°. At the end of treatment, 94% of patients were classified as having grade 0 or I sesamoid lateral sub-luxation. Given improvement in angles and 90% of patients satisfied with an average AOFAS postoperative score of 90, the technique seems indicated for treatment of symptomatic hallux valgus deformity with increased DMAA.

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