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KMID : 1130920200240040129
Journal of Korean Foot and Ankle Society
2020 Volume.24 No. 4 p.129 ~ p.134
A Comparison of Proximal and Distal Chevron Osteotomy for the Correction of Severe Hallux Valgus Deformity
Park Hyung-Seok

Lee Jun-Young
Ko Kang-Yeol
Ryu Je-Hong
Lim Jae-Hwan
Abstract
Purpose: This study compared the results of proximal and distal chevron osteotomy in patients with severe hallux valgus. Several recent studies have shown that the indications for distal metatarsal osteotomy with a distal soft-tissue procedure could be extended to include severe hallux valgus.

Materials and Methods: This study analyzed 127 severe hallux valgus surgeries. Of these, 76 patients (76 feet) were excluded for lack of adequate follow-up and additional procedures (Akin procedure), leaving 51 patients (51 feet) in the study. The mean age of the pa?tients was 58 years (21~83 years), and the mean follow-up duration was 18 months (12~32 months). The patients were divided into two groups. Group 1 underwent distal chevron osteotomy, and group 2 underwent proximal chevron osteotomy performed sequentially by a single surgeon. The patients were interviewed for the American Orthopaedic Foot and Ankle Society (AOFAS) score before and one year after surgery. The anteroposterior weight-bearing radiography of the foot was taken before and one year after surgery.

Results: There were no significant differences in pain and function after one year in either group. Both groups experienced significant pain reduction and an increase in the AOFAS score. Significant improvement of the hallux valgus and intermetatarsal angle corrections was observed in both groups, and the sesamoid position was similar in each group. More improvement in radiographic correction of in?termetatarsal angle was noted in group 2. Both procedures gave similar good clinical and radiological outcomes.

Conclusion: This study suggests that a distal chevron osteotomy with a distal soft-tissue procedure is as effective and reliable a means of correcting severe hallux valgus as a proximal chevron osteotomy with a distal soft-tissue procedure.
KEYWORD
Foot, Severe hallux valgus, Distal metatarsal osteotomy
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