Chevron Osteotomy as the Treatment of Moderate to Severe Hallux Valgus Deformity

Choi, Jang Seok; Kim, Young Chang; Seo, Seung Seok; Ahn, Ki Chan; Kim, Jin Wan

Abstract

Chevron osteotomy is one of the most widely used distal metatarsal osteotomies in the treatment of hallux valgus in adults. We performed chevron osteotomy on 11 feet (7 patients), and the combination of proximal metatarsal osteotomy and distal soft tissue procedure on 6 feet (4 patients) for painful hallux valgus associated with an increased hallux valgus angle (>35 degrees) and 1/2 intermetatarsal angle (>13 degrees). The results were as follows: 1. In the chevron osteotomy, the average correction of hallux valgus angle was 28.8 (19-36) degrees and the average loss of correction was 7.6 (3-18) degrees. The average correction of 1/2 intermetatarsal angle was 7.8 (6-13) degrees and the average loss of correction was 4.3 (1-10) degrees. 2. In the combination of proximal metatarsal osteotomy and distal soft tissue procedure, the aver age correction of hallux valgus angle was 34.3 (26-42) degrees and the average loss of correction was 4 (1-7) degrees. The average correction of 1/2 intermetatarsal angle was 9.8 (4-14) degrees and the average loss of correction was 2 (0-5) degrees. 3. The radiographic result of the combination method was significantly better statistically than that of the chevron osteotomy alone. 4. In the chevron osteotomy, the metatarsalgia of the great toe was subsided in 10 of 11 feet (91%) and the patients were satisfied with the cosmetic and functional result of their operation. Recurrence of hallux valgus deformity and superficial wound infection were seen in each case (9.1%). 5. In the combination of proximal metatarsal osteotomy and distal soft tissue procedure, the metatarsalgia of the great toe was subsided in all feet and postoperative complication was not found. In our studies, the chevron osteotomy applied to moderate to severe hallux valgus deformity was found as a relatively good radiographic result, but a recurrence of hallux valgus deformity was checked, compared with the combination of proximal metatarsal osteotomy and distal soft tissue procedure. Therefore, the chevron osteotomy can be applied to moderate to severe hallux valgus deformity but for the best result, the other procedure in addition will be necessary.