Biplanar versus Triplanar Chevron Osteotomy for the Correction of Hallux Valgus: A Comparison of Radiologic Outcomes

Abstract

Introduction: Hallux valgus is a common disorder of the foot. The chevron osteotomy is among the most common methods of surgically correcting mild to moderate hallux valgus, though it has been associated with inadequate distal metatarsal articular angle (DMAA) correction and risk of hallux valgus recurrence. This study aimed to compare the effectiveness of the triplanar and biplanar chevron osteotomies in correcting mild to moderate hallux valgus. Specifically, we aimed to determine if the triplanar chevron osteotomy results in superior correction of the DMAA compared to the biplanar chevron osteotomy. Methods: A retrospective review of patient medical charts and preoperative and postoperative radiographs was performed. A total of 55 patients were included, with 28 patients in the biplanar chevron group and 27 patients in the triplanar chevron group. The DMAA and intermetatarsal (IM) angles were measured on preoperative and postoperative radiographs. Statistical analysis was carried out on SPSS. Results: The DMAA and IM angles improved significantly in both groups (p = <0.001). There was no significant difference in the mean postoperative IM angle in the biplanar versus triplanar groups (9.58 degrees versus 9.19 degrees, respectively, p = 0.279). There was a significant difference in the mean postoperative DMMA in the triplanar versus biplanar groups (7.88 degrees versus 8.79 degrees, respectively, p = 0.026). Conclusions: The biplanar and triplanar chevron osteotomies are equally effective in reducing IM angle in mild to moderate hallux valgus. The triplanar chevron osteotomy significantly increases DMAA correction when compared to the biplanar chevron osteotomy and may therefore reduce hallux valgus recurrence.