Clinico-radiological Results of Distal Chevron Osteotomy without Lateral Soft Tissue Release in Mild to Moderate Hallux Valgus Deformity

2021 ◽  
Vol 23 (4) ◽  
pp. 287-293
Author(s):  
Mohd Rafeeq Wani ◽  
Mohd Iqbal Wani ◽  
Arshid Bashir ◽  
Manzoor Ahmad Halwai ◽  
Stanzin Sonum ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Hallux Valgus ◽  
Valgus Deformity ◽  
Soft Tissue Release ◽  
Average Value ◽  
Radiological Results ◽  
Chevron Osteotomy ◽  
Hallux Valgus Deformity ◽  
A Prospective Study

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.

scholarly journals Outcomes of Scarf and Akin Osteotomy with Intra-Articular Stepwise Lateral Soft Tissue Release for Correcting Hallux Valgus Deformity in Rheumatoid Arthritis

2021 ◽  
Vol 18 (20) ◽  
pp. 10667
Author(s):  
Takumi Matsumoto ◽  
Yuji Maenohara ◽  
Song Ho Chang ◽  
Kumiko Ono ◽  
Yasunori Omata ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Soft Tissue ◽  
Hallux Valgus ◽  
Valgus Deformity ◽  
Soft Tissue Release ◽  
Intermetatarsal Angle ◽  
Hallux Valgus Deformity ◽  
Patient Reported ◽  
Akin Osteotomy

Background. The effectiveness of scarf and Akin osteotomy with intra-articular lateral soft tissue release for the correction of hallux valgus (HV) in patients with rheumatoid arthritis (RA) has not been elucidated. Methods. A total of 36 feet in 28 patients with RA who had scarf and Akin osteotomy with intra-articular stepwise lateral soft tissue release between 2015 and 2020 at a single institute were investigated retrospectively, with a mean follow-up period of 32.0 ± 16.9 months. Radiographic evaluations including the HV angle, intermetatarsal angle, and sesamoid position were performed preoperatively and postoperatively. Clinical outcomes were assessed using the Japanese Society of Surgery of the Foot (JSSF) hallux scale and self-administered foot evaluation questionnaire (SAFE-Q). Results. The procedure resulted in significant HV correction, with a recurrence rate of 13.9%. The JSSF scale and all five SAFE-Q subscale scores significantly improved (p < 0.05), with no major complications. More than 90% of cases achieved adequate lateral soft tissue release without sacrificing the adductor tendon of the hallux. Conclusions. Intra-articular stepwise lateral soft tissue release in combination with scarf and Akin osteotomy provided satisfactory radiographic and patient-reported outcomes for the correction of HV in patients with RA with minimum lateral soft tissue release.

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.

Modified Chevron Osteotomy for Hallux Valgus

1994 ◽  
Vol 15 (12) ◽  
pp. 642-645 ◽  
Author(s):  
Richard E. Donnelly ◽  
Charles L. Saltzman ◽  
Todd A. Kile ◽  
Kenneth A. Johnson
Keyword(s):  
Hallux Valgus ◽  
Screw Fixation ◽  
Valgus Deformity ◽  
Chevron Osteotomy ◽  
Hallux Valgus Deformity ◽  
Long Term Follow Up ◽  
Reliable Procedure ◽  
Shoe Wear

The chevron osteotomy for hallux valgus was modified by addition of screw fixation and change of the osteotomy angle. Thirty-six patients underwent this modified osteotomy. All had mild to moderate symptomatic hallux valgus deformities. No other forefoot procedures were performed. Standing radiographs were taken before surgery, at 1 month after surgery, and, for the 15 patients who returned for long-term follow-up, at 1 year or more after surgery. Overall, 35/42 procedures were rated as satisfactory without reservations and 7 were rated as satisfactory with mild reservations. All patients stated that they had some improvement in their preoperative symptoms, which included pain, cosmetic concerns, and shoe wear difficulties. Radiographically, none of the capital fragments displaced and there were no malunions, nonunions, nor evidence of avascular necrosis. The average metatarsophalangeal-1 angle improved 8° and the average intermetatarsal 1–2 angle improved 4°. This modification is relatively simple, increases stability, and allows early weightbearing. In our experience, the modified chevron osteotomy has been a very reliable procedure for mild to moderate symptomatic hallux valgus deformity.

scholarly journals Is Generalized Ligamentous Laxity a Prognostic Factor for Recurred Hallux Valgus Deformity?

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0018
Author(s):  
Byung-Ki Cho ◽  
Seung-myung Choi
Keyword(s):  
Hallux Valgus ◽  
Postoperative Recurrence ◽  
Valgus Deformity ◽  
Foot And Ankle ◽  
Hallux Valgus Angle ◽  
Ligamentous Laxity ◽  
Chevron Osteotomy ◽  
Hallux Valgus Deformity ◽  
Valgus Angle

Category: Bunion Introduction/Purpose: It is still unclear whether generalized ligamentous laxity is a risk factor for recurred hallux valgus deformity. This study was performed to evaluate the intermediate-term clinical outcomes after proximal chevron osteotomy for hallux valgus in patients with generalized ligamentous laxity, and to determine the effect on postoperative recurrence of deformity. Methods: A total of 198 feet from 169 female patients were treated with a proximal chevron osteotomy for hallux valgus with a mean follow-up of 46.3 months. When generalized ligamentous laxity was defined as Beighton score ≥ 5 points, there were 18 patients (10.7%) in laxity group and 151 patients (89.3%) in non-laxity group. Clinical evaluation consisted of the American Orthopaedic Foot and Ankle Society (AOFAS) scores, Foot and Ankle Ability Measure (FAAM), and radiographic measurement of hallux alignment. Risk factors associated with postoperative recurrence were evaluated using univariate analysis. Results: Recurrence rates were 21.7% in the laxity group and 17.1% in non-laxity group (p = 0.218), when defined as hallux valgus angle ≥ 20°. No significant differences of measurement at final follow-up were found between the 2 groups in terms of AOFAS score, FAAM, recurrence rate, hallux valgus angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA). Preoperative HVA and IMA were found to be predictive factors of recurrence (OR = 6.3, 4.2; P = .001, .018, respectively). Conclusion: There were no statistical differences in the clinical and radiographic outcomes between hallux valgus with and without generalized ligamentous laxity. Generalized ligamentous laxity demonstrated no definitive effects on postoperative recurrence of hallux valgus deformity.

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