Evaluation of an Innovative Fixation System for Chevron Bunionectomy

Bennett, Gordon L.; Sabetta, James A

doi:10.1177/1071100715607006

Cited by 10 publications

(10 citation statements)

References 26 publications

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“…In the patients with double osteotomy bunionectomy, we did not need to tighten the capsule as much as we did in the chevron bunionectomy alone group to obtain correction of the hallux valgus, which we reported on previously. 3 All patients in our group were either satisfied or satisfied with minor reservations. All patients reported that they would have the procedure done again if given the choice.…”

Section: Resultsmentioning

confidence: 86%

“…The ISO technique has been employed by us since 2011 for the correction and stabilization of mild to moderate hallux valgus with predictable outcomes. 3 Chevron osteotomy continues to be a reliable method for treating mild to moderate hallux valgus. [7][8][9]11 We continue to perform the ISO operative technique as outlined in the Operative Technique section; however, we elected to add the Akin proximal phalanx osteotomy to maintain and enhance correction, address minor rotational deformity, and obtain improved cosmesis.…”

Section: Discussionmentioning

confidence: 99%

“…In patients with pain not responsive to footwear and activity modification, chevron distal metatarsal osteotomy bunionectomy is a commonly performed and highly successful procedure for the treatment of mild and moderate hallux valgus. 3,4,6 We have previously reported our results in a prospective study of 57 patients who underwent chevron bunionectomy in which the metatarsal osteotomy was stabilized with an intramedullary plate system, 3 which secures the metatarsal shaft to the first metatarsal head after lateral displacement of the metatarsal head. The intramedullary device is secured to the head and shaft with 2.4-mm screws.…”

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confidence: 98%

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Intraosseous Sliding Plate Fixation Used in Double Osteotomy Bunionectomy

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Hallux valgus is a very common orthopedic problem. In patients with pain not responsive to footwear and activity modification, chevron distal metatarsal osteotomy bunionectomy is a commonly performed and highly successful procedure for the treatment of mild and moderate hallux valgus. 3,4,6 We have previously reported our results in a prospective study of 57 patients who underwent chevron bunionectomy in which the metatarsal osteotomy was stabilized with an intramedullary plate system, 3 which secures the metatarsal shaft to the first metatarsal head after lateral displacement of the metatarsal head. The intramedullary device is secured to the head and shaft with 2.4-mm screws. Although our results with this technique were good, we wanted to evaluate the potential added benefit of performing an Akin osteotomy of the proximal phalanx in addition to the metatarsal osteotomy. This is the double osteotomy bunionectomy. When we first started performing this procedure, we observed that we were able to achieve a better cosmetic result with less aggressive tightening of the medial capsule and better range of motion of the first metatarsophalangeal (MTP) joint. Although most series of bunionectomies have good patient satisfaction, we wanted to see if the double osteotomy bunionectomy technique would result in a higher degree of patient satisfaction and better cosmesis. The purpose of this study was to prospectively evaluate the results of double osteotomy bunionectomy in a consecutive group of 138 patients operated on by a single surgeon over a 2-year period of time. Methods We performed double osteotomy bunionectomies on 138 consecutive patients (145 feet) between June 13, 2013, and March 18, 2015. All operative procedures were performed 800635F AIXXX10.

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Section: Resultsmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

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confidence: 98%

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Intraosseous Sliding Plate Fixation Used in Double Osteotomy Bunionectomy

et al. 2018

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“…Recently, an innovative intramedullary device was introduced for the fixation of the capital fragment in the distal metatarsal chevron osteotomy (4,5,15 The utilization of the metallic alloy implants could have been complicated with implant irritation and implant removal surgery may be warranted in some situations. In our study, the locking plate and the intramedullary device both had low profile feature.…”

Section: Discussionmentioning

confidence: 99%

Halluks Valgus Cerrahisinde Distal Metatars Chevron Osteotomisinin Kilitli Plak ve İntramedüller Cihaz ile Tespitinin Geriye Dönük Olarak Karşılaştırılması.

Sarı¹,

Sevgili²,

Karakuş³

2019

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi

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Objective: Recently, an innovative intramedullary device was introduced for the fixation of the capital fragment in the distal metatarsal chevron osteotomy. The aim of the present study was to compare the outcomes of locking plate and intramedullary device fixation in the distal metatarsal chevron osteotomy in the surgical treatment of hallux valgus. Material and Methods: We reviewed 29 patients (29 feet) treated with distal metatarsal chevron osteotomies fixated by locking plate or intramedullary device for hallux valgus. Locking plate fixation were used for 14 patients (14 feet) and intramedullary device fixation were used for 15 patients (15 feet). Results: The mean follow-up period was 31 (6-56) months. The locking plate and intramedullary device groups did not differ significantly with respect to age, affected side, surgical time, duration of hospital stay, followup period or postoperative American Orthopedic Foot and Ankle Society scores (p>0.05). The hallux valgus angle and the intermetatarsal angle decreased significantly in both the locking plate and the intramedullary device groups (p<0.01). Two patients (14.3%) in the locking plate group and 5 patients (33.3%) in the intramedullary device group had implant removal surgery because of implant irritation but the difference in implant removal rates were not statistically significant. Conclusion: We found both locking plate and intramedullary device fixation methods were effective in the fixation of distal metatarsal chevron osteotomy for correction of moderate hallux valgus. However, both locking plate and intramedullary device fixation methods were associated with a relatively high implant removal rate.

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“…28 This procedure was first described in 1981, and some modifications to this technique have been publicized, most recently adding focus on the fixation methods. 1-3 Numerous publications presenting the radiological outcomes and the clinical outcomes have been published. 5,18,20,27 One of the advantages of this method is its nature of a joint-preserving technique.…”

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confidence: 99%

Loss of Correction After Chevron Osteotomy for Hallux Valgus as a Function of Preoperative Deformity

Kaufmann¹,

Sinz

Giesinger

et al. 2018

Foot Ankle Int.

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Background: Recurrence is relatively common after surgical correction of hallux valgus. Multiple factors are discussed that could have an influence in the loss of correction. The aim of this study was to determine preoperative radiological factors with an influence on loss of correction after distal chevron osteotomy for hallux valgus. Methods: Five hundred twenty-four patients who underwent the correction of a hallux valgus by means of distal chevron osteotomy at our institution between 2002 and 2012 were included. We assessed weightbearing x-rays at 4 time points: preoperatively, postoperatively, and after 6 weeks and 3 months. We investigated the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA), joint congruity, and the position of the sesamoids. Results: At all points of the survey, significant correction of the IMA and HVA was detected. The IMA improved from 12.9 (± 2.8) to 4.5 (± 2.4) degrees and the HVA from 27.5 (± 6.9) to 9.1 (± 5.3) degrees. Loss of correction was found in both HVA and IMA during follow-up with a mean of 4.5 and 1.9 degrees, respectively. Loss of correction showed a linear correlation with preoperative IMA and HVA, and a correlation between preoperative DMAA and sesamoid position. Conclusion: The chevron osteotomy showed significant correction for HVA, IMA, and DMAA. Preoperative deformity, in terms of IMA, HVA, DMAA, and sesamoid position, correlated with the loss of correction and could be assessed preoperatively for HVA and IMA. Loss of correction at 3 months persisted during the follow-up period. Level of Evidence: Level IV, retrospective case series.

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Evaluation of an Innovative Fixation System for Chevron Bunionectomy

Abstract: Level IV, retrospective case series.

Cited by 10 publications

References 26 publications

Intraosseous Sliding Plate Fixation Used in Double Osteotomy Bunionectomy

Intraosseous Sliding Plate Fixation Used in Double Osteotomy Bunionectomy

Halluks Valgus Cerrahisinde Distal Metatars Chevron Osteotomisinin Kilitli Plak ve İntramedüller Cihaz ile Tespitinin Geriye Dönük Olarak Karşılaştırılması.

Loss of Correction After Chevron Osteotomy for Hallux Valgus as a Function of Preoperative Deformity

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