Comparison of the Proximal Chevron and Ludloff Osteotomies for the Correction of Hallux Valgus

Abstract

The proximal chevron and Ludloff osteotomies yielded equivalent clinical and radiological results. The Ludloff osteotomy with lag screw fixation is more stable and does not require postoperative hardware removal, although it is technically demanding and has a tendency toward greater shortening of the first metatarsal.

Open wedge metatarsal osteotomy versus crescentic osteotomy to correct severe hallux valgus deformity – A prospective comparative study

“…Radiologically, the total HVA correction in this study was comparable to other hallux valgus correcting studies using similar operation methods [7,13,18,19]. In these studies, the preoperative HVA was only ranging from 7 to 320 resulting in a final HVA considerably lower postoperatively compared to our study.…”

“…The Akin procedure is used to correct the pronation deviation of the proximal phalanx and to correct hallux valgus interphalangealis, when this is still persisting after Foot and Ankle Surgery xxx (2015) xxx-xxx correcting the hallux valgus (HVA) and inter-metatarsal (IMA) angle [17]. Only very few prospective randomized investigations comparing different operation methods for hallux valgus have been published [8,12,13]. In our department the distal chevron procedure is used for patients with a HVA less than 35 degrees and an IMA less than 15 degrees [8].…”

“…Numerous techniques have been introduced and published regarding correcting hallux valgus. The operation techniques can be divided into distal metatarsal osteotomy (DMO), mid-shaft osteotomies or proximal metatarsal osteotomy (PMO) [1,[12][13][14][15][16]. The Akin procedure is used to correct the pronation deviation of the proximal phalanx and to correct hallux valgus interphalangealis, when this is still persisting after Foot and Ankle Surgery xxx (2015) xxx-xxx correcting the hallux valgus (HVA) and inter-metatarsal (IMA) angle [17].…”

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

“…16,[32][33][34][35] It is, however, less stable than a DCO because of its longer lever arm and the geometry of the osteotomy, which has less contact surface owing to the medial gap left after lateral angulation and supination. 8,22 Although either a DCO or a PCO can be used for patients with moderate hallux valgus, no study has compared the results of the two osteotomies.…”

“…Osteotomy involving the diaphyseal area, such as the Scarf or Ludloff osteotomy, has been compared with either distal or proximal osteotomy. [20][21][22] However, to the best of our knowledge there have been no previous studies comparing the results of distal and proximal metatarsal osteotomy in patients with moderate hallux valgus, and this was our aim. Our hypothesis was that proximal chevron osteotomy (PCO) could achieve better clinical and radiological results than DCO.…”