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 TL 18129 - Surgical treatment of hallux valgus using the percutaneous chevron technique

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 85S
Author(s):  
Fábio Lemos Rodrigues ◽  
Luiz Carlos Ribeiro Lara ◽  
Juan Antônio Grajales ◽  
Lucio Carlos Azevedo Torres Filho
Keyword(s):  
Surgical Treatment ◽  
Hallux Valgus ◽  
Aofas Score ◽  
First Metatarsal ◽  
Chevron Osteotomy ◽  
Valgus Angle ◽  
Angular Correction ◽  
Before And After ◽  
The Mean ◽  
Severe Hallux Valgus

Objective: To clinically and radiographically observe the outcomes of the surgical treatment of moderate and severe hallux valgus using percutaneous distal chevron osteotomy. Methods: A total of 35 feet (33 patients) with moderate and severe hallux valgus were evaluated using the Couhling classification from June 2016 to January 2018. The mean patient age was 53 years, and the mean postoperative follow-up time was 13 months. All patients who underwent chevron osteotomy were evaluated before and after surgery using the American Orthopedic Foot and Ankle Society (AOFAS) scale. We measured the hallux valgus angle (HVA), the intermetatarsal angle (IMA) and the distal metatarsal articular angle (DMAA) using radiographic studies. Results: The AOFAS score increased by a mean of 54 points. The HVA decreased by a mean of 19°, the IMA by 7° and the DMAA by 11°. The median decrease in the length of the first metatarsal bone was 0.35 cm. Conclusion: Chevron osteotomy using the percutaneous surgical technique made it possible to correct moderate and severe hallux valgus deformities, with excellent angular correction and a significant increase in the AOFAS score.

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 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.

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.

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 Surgical treatment of hallux valgus using a modified Reverdin-Isham technique

2021 ◽  
Vol 15 (1) ◽  
pp. 49-53
Author(s):  
Luiz Lara ◽  
Lúcio Torres Filho ◽  
Gabriel Cervone ◽  
Juan Grajales ◽  
Glaucia Bordignon ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hallux Valgus ◽  
Case Series ◽  
Metatarsal Head ◽  
Level Of Evidence ◽  
Valgus Angle ◽  
Significant Correction ◽  
The Mean ◽  
American Orthopaedic

Objective: To evaluate the postoperative results of patients who underwent surgical treatment of hallux valgus with a modified Reverdin-Isham (RI) technique and to compare the achieved correction with that reported by studies using the original technique. Methods: This is a retrospective study with patients with mild to moderate hallux valgus who underwent surgery from June 2010 to July 2019. All patients were operated using the modified RI technique. Data were collected through the American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire, in addition to pre and postoperative radiographic studies of the intermetatarsal angle (IMA), the hallux valgus angle (HVA), and the distal metatarsal articular angle (DMAA). Results: The mean postoperative follow-up was 30.1 months, and the mean age of patients was 56.4 years. The median AOFAS score in the postoperative period was increased by 56 points. The mean HVA was reduced in 16.5°, the mean IMA was reduced in 4.3°, and the mean DMAA was reduced in 10°. There were no cases of displacement or deviation of the first metatarsal head during the postoperative follow-up. Conclusion: The modified RI technique provided considerable stability to the osteotomy, in addition to a significant correction of the measured angles and an improvement in AOFAS scores, demonstrating itself as an effective technique for correcting mild to moderate hallux valgus. 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.

Modified Austin Procedure for Correction of Hallux Valgus

1997 ◽  
Vol 18 (3) ◽  
pp. 119-127 ◽  
Author(s):  
Hans-Jörg Trnka ◽  
Alexander Zembsch ◽  
Hermann Wiesauer ◽  
Marc Hungerford ◽  
Martin Salzer ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Hallux Valgus ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Hallux Valgus Angle ◽  
First Metatarsophalangeal Joint ◽  
Intermetatarsal Angle ◽  
Soft Tissue Procedure ◽  
Valgus Angle

The Austin osteotomy is a widely accepted method for correction of mild and moderate hallux valgus. In view of publications by Kitaoka et al. in 1991 and by Mann and colleagues, a more radical lateral soft tissue procedure was added to the originally described procedure. From September 1992 to January 1994, 85 patients underwent an Austin osteotomy combined with a lateral soft tissue procedure to correct their hallux valgus deformities. Seventy-nine patients (94 feet) were available for follow-up. The average patient age at the time of the operation was 47.1 years, and the average follow-up was 16.2 months. The average preoperative intermetatarsal angle was 13.9°, and the average hallux valgus angle was 29.7°. After surgery, the feet were corrected to an average intermetatarsal angle of 5.8° and an average hallux valgus angle of 11.9°. Sesamoid position was corrected from 2.1 before surgery to 0.5 after surgery. The results were also graded according to the Hallux Metatarsophalangeal Interphalangeal Score, and the functional and cosmetic outcomes were graded by the patient. Dissection of the plantar transverse ligament and release of the lateral capsule repositioned the tibial sesamoid and restored the biomechanics around the first metatarsophalangeal joint. There was no increased incidence of avascular necrosis of the first metatarsal head compared with the original technique.

scholarly journals Radiographic Recurrence of Hallux Valgus Based on Osteotomy Location

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0021
Author(s):  
Andrew Federer ◽  
Travis Dekker ◽  
David Tainter ◽  
Jordan Liles ◽  
Mark Easley ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Surgical Correction ◽  
P Value ◽  
Single Individual ◽  
Hallux Valgus Angle ◽  
Intermetatarsal Angle ◽  
Valgus Angle ◽  
Significant Difference

Category: Bunion Introduction/Purpose: Hallux valgus (HV) is one of the most common deformities of the foot resulting in pain and lifestyle modification of the patient. Recurrence rates of 10-47% have been documented in single individual osteotomy series. Unfortunately, surgical correction and recurrence are often defined as changes related to normal radiographs and not actually as the magnitude of correction lost with follow-up. Currently there have not been studies evaluating the percentage of recurrence of intermetatarsal angle (IMA) and hallux valgus angle (HVA). As there is substantial difference in starting IMA and HVA, as well as amount of surgical correction, our goal was to evaluate the percentage loss of correction over time comparing preoperative, initial postoperative and minimum of 2-year follow up radiographs among three different surgical correction techniques. Methods: This is a retrospective chart review study that examines the weight-bearing radiographic measurements of patients undergoing hallux valgus corrective surgery at a single institution over 5 years. Fifty-three patients were divided into first tarsometatarsal arthrodesis (i.e. Lapidus), mid-diaphyseal osteotomies (i.e. scarf), and distal metatarsal osteotomies (i.e. chevron). The preoperative, initial postoperative, and final follow up weight-bearing radiographs were measured for intermetatarsal angle (IMA) and hallux valgus angle (HVA). Primary outcome was percentage of recurrence of IMA and HVA, with the difference in angles between preoperative and initial postoperative weight-bearing films being considered 100% correction. The percentage of recurrence between initial postoperative and most recent follow up was then calculated (Figure 1A). A one-way analysis of variance (ANOVA) test and post-hoc Tukey-Kramer tests were used to compare preoperative IMA and HVA and percentage recurrence of IMA and HVA at most recent follow up. Results: There was no significant difference between Lapidus (14.3deg) and mid-diaphyseal osteotomies (12.7deg) in preoperative IMA (p-value=0.26). There was a significant difference between Lapidus (-0.3deg) and mid-diaphyseal (2.8deg) osteotomies for degree of hallux valgus recurrence as measured by IMA between initial postoperative films and final 2-year follow up (p-value=0.009). Lapidus procedure showed a greater magnitude decrease in IMA degrees from preoperation to final follow up compared to distal osteotomy (p-value=0.037) and trended toward significance compared to mid-diaphyseal (p-value=0.056). Mid-diaphyseal osteotomies (30%) showed a statistically significant higher percentage of IMA recurrence compared to Lapidus (-11%) (p-value=0.0014) (Figure 1B). When comparing percentage recurrence of HVA, distal osteotomies had a significantly smaller rate of recurrence when compared to the diaphyseal osteotomies (p-value=0.030). Conclusion: Though Lapidus and mid-diaphyseal osteotomies were performed for patients with a similar preoperative IMA, mid-diaphyseal osteotomies had a significantly higher percentage of recurrence at 2-year follow up compared to Lapidus procedures. Moreover, Lapidus procedures trended toward greater overall of IMA correction compared to mid-diaphyseal osteotomies. When either a Lapidus or mid-diaphyseal osteotomy is indicated, a Lapidus procedure may result in decreased rate of radiographic recurrence of hallux valgus at 2 years.

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.

Sign in / Sign up

Export Citation Format

Share Document