A comparison of proximal and distal chevron osteotomy for the correction of moderate hallux valgus deformity

Abstract

The purpose of this study was to compare the results of proximal and distal chevron osteotomy in patients with moderate hallux valgus. We retrospectively reviewed 34 proximal chevron osteotomies without lateral release (PCO group) and 33 distal chevron osteotomies (DCO group) performed sequentially by a single surgeon. There were no differences between the groups with regard to age, length of follow-up, demographic or radiological parameters. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system and the radiological results were compared between the groups. At a mean follow-up of 14.6 months (14 to 32) there were no significant differences in the mean AOFAS scores between the DCO and PCO groups (93.9 (82 to 100) and 91.8 (77 to 100), respectively; p = 0.176). The mean hallux valgus angle, intermetatarsal angle and sesamoid position were the same in both groups. The metatarsal declination angle decreased significantly in the PCO group (p = 0.005) and the mean shortening of the first metatarsal was significantly greater in the DCO group (p < 0.001). We conclude that the clinical and radiological outcome after a DCO is comparable with that after a PCO; longer follow-up would be needed to assess the risk of avascular necrosis.

Angular correction and complications of proximal first metatarsal osteotomies for hallux valgus deformity

“…Recently, Park et al compared proximal and distal chevron osteotomies in 77 feet [69]. In contrast to the results of our study compared with the meta-analysis of Smith et al they found no statistically significant difference for correction of HVA and IMA.…”

Chevron Versus Mitchell Osteotomy in Hallux Valgus Surgery: A Comparative Study

“…Fokter et al (1) reported on the late results of the Mitchell osteotomy with a mean corrected IMA of 7.7 . The amount of shortening of the first metatarsal in the chevron osteotomy group was also comparable to that reported in current studies (4.2 mm) (24).…”

Distal soft tissue procedure in hallux valgus surgery: biomechanical background and technique

“…This soft tissue procedure aims to restore the physiological balance of capsular, ligamentous and muscular structures around the first metatarsophalangeal (MTP) joint. During the last decades worldwide scientific discussions, clinical surveys [1][2][3][4][5][6][7][8], anatomical studies [9,10] and experimental set-ups [11][12][13][14] have helped to clarify open questions about soft tissue procedures: is it necessary in every case of bunion surgery and is there a technique superior in respect of high efficiency and low risk? Certain reservations exist regarding the combination of distal soft tissue procedures and distal metatarsal osteotomies.…”