Abstract
The purpose of this brief paper is to present the preliminary results of a modified Austin/chevron osteotomy for treatment of hallux valgus and hallux rigidus. In this procedure, the dorsal arm of the osteotomy is performed orthogonal to the horizontal plane of the first metatarsal, the main advantage being that this allows much easier and more accurate multiplanar correction of first metatarsal deformities. From 2010 to 2013, 184 consecutive patients with symptomatic hallux valgus and 48 patients with hallux rigidus without severe metatarsophalangeal joint degeneration underwent such modified chevron osteotomy. Mean patient age was 54.9 (range 21–70) years, and mean follow-up duration was 41.7 (range 24–56) months. Ninety-three percent of patients were satisfied with the surgery. Mean American Orthopaedic Foot and Ankle Society (AOFAS) score improved from 56.6 preoperatively to 90.6 at last follow-up, and mean visual analog scale (VAS) pain score decreased from 5.7 preoperatively to 1.6 at final follow-up (p < 0.05). In patients treated for hallux valgus, mean hallux valgus angle decreased from 34.1° preoperatively to 6.2° at final follow-up, and mean intermetatarsal angle decreased from 18.5° preoperatively to 4.1° at final follow-up (p < 0.05). One patient developed postoperative transfer metatarsalgia, treated successfully with second-time percutaneous osteotomy of the minor metatarsals, whilst one patient had wound infection that resolved with systemic antibiotics.Level of evidenceLevel IV.
Highlights
Numerous corrective osteotomies have been described for surgical treatment of hallux valgus (HV), but none of them addresses all cases
This article is published with open access at Springerlink.com. The purpose of this brief paper is to present the preliminary results of a modified Austin/chevron osteotomy for treatment of hallux valgus and hallux rigidus
In patients treated for hallux valgus, mean hallux valgus angle decreased from 34.1° preoperatively to 6.2° at final follow-up, and mean intermetatarsal angle decreased from 18.5° preoperatively to 4.1° at final follow-up (p \ 0.05)
Summary
Numerous corrective osteotomies have been described for surgical treatment of hallux valgus (HV), but none of them addresses all cases One of these procedures, known for its optimal intrinsic mechanical stability, is the Austin/chevron procedure [1, 2], a V-shaped distal osteotomy, traditionally indicated for correction of mild to moderate HV, in which the hallux valgus angle (HVA) is less than 30° and the intermetatarsal angle (IMA) is less than 15° [2]. Many variants of the standard chevron have been proposed All these variants require that the two arms of the osteotomy be oblique to the horizontal plane of the first metatarsal. A new modification of the chevron osteotomy was proposed, requiring that the dorsal arm of the osteotomy be performed orthogonal to the horizontal plane of the first metatarsal. J Orthopaed Traumatol (2016) 17:89–93 of moderate hallux rigidus (HR) [4], and of fixing the final osteotomy with a single screw
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