J Korean Orthop Assoc.  2008 Aug;43(4):445-450. 10.4055/jkoa.2008.43.4.445.

Distal Chevron Osteotomy for Moderate to Severe Hallux Valgus Deformity in Patients Aged 50 or Older

• Yoo WJ
• Chung MS
• Baek GH
• Yu CH
• Moon HJ

• KMID: 1480404
• DOI: http://doi.org/10.4055/jkoa.2008.43.4.445

Abstract

PURPOSE: The purpose of this study was to analyze the clinical and radiological results of distal chevron osteotomy in patients aged 50 and older with moderate-to-severe hallux valgus.
MATERIALS AND METHODS
The authors reviewed the medical records and radiographs of 19 patients (26 feet). Average age at time of surgery was 58 years and the mean follow-up period was 3 years and 1 month. For radiological evaluation, we analyzed changes in hallux valgus angles and 1st-2nd intermetatarsal angles after index operations. Clinical results were assessed with respect to pain, activities of daily living, and shoe-wear.
RESULTS
Hallux valgus angles and 1st-2nd intermetatarsal angles improved, but considerable correction loss occurred with time. This correction loss was found to be significantly correlated with preoperative subluxation of the 1st metatarsophalangeal joint and the 1st-2nd intermetatarsal angle. Clinically, remarkable improvements were achieved in terms of pain and level of activity, but most patients (except 4) still wore comfortable shoes rather than hard shoes at latest follow-ups.
CONCLUSION
Distal chevron osteotomy is beneficial for patients aged 50 and older with moderate-to- severe hallux valgus deformity, but correction loss may occur in patients with marked subluxation of the 1st metatarsophalangeal joint or a severe 1st-2nd intermetatarsal angle.

Keyword

Hallux valgus; Distal chevron osteotomy

MeSH Terms

Activities of Daily Living
Aged
Congenital Abnormalities
Follow-Up Studies
Hallux
Hallux Valgus
Humans
Medical Records
Metatarsophalangeal Joint
Osteotomy
Shoes

Figure

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  Fig. 1 A 66-year old female with hallux valgus foot deformity. (A) Preoperatively, the 1st-2nd intermetatarsal angle was 16° and 1st metatarsophalangeal joint subluxation was 12%. (B) The deformity was corrected by distal chevron osteotomy. Postoperatively, the 1st-2nd intermetatarsal angle was 4°. (C) However, 10 years after the operation, the hallux valgus angle had increased to 32°, and the 1st-2nd intermetatarsal angle to 10°, and the metatarsophalangeal joint was subluxated. Nevertheless, the patient reported only mild discomfort.

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