Comparison of open lateral release and transarticular lateral release in distal chevron metatarsal osteotomy for hallux valgus correction

Abstract

The aim of this study was to investigate the difference in clinical and radiographic outcomes between conventional open lateral soft tissue release (OLSTR) and transarticular lateral soft tissue release (TLSTR) in patients undergoing distal chevron metatarsal osteotomy (DCMO) for hallux valgus (HV) correction. This study included weight-bearing anteroposterior radiographs of 138 patients (185feet) with HV that underwent DCMO and Akin phalangeal osteotomy at a mean age of 51.7years (21-74) with a mean 26months of follow-up between June 2004 and June 2010. Patients were classified into two groups: OLSTR as group 1 (84feet) and TLSTR as group 2 (101feet). We evaluated clinical and radiographic outcomes between the two groups using the American Orthopaedic Foot and Ankle Society hallux score, visual analogue scale pain score, hallux valgus angle, intermetatarsal angle and complications, pre- and post-operatively. There were no significant differences between the two groups except for post-operative complications such as first metatarsophalangeal joint (MTPJ) stiffness (group 1) and post-operative hallux varus (group 2). Clinical and radiographic outcomes between OLSTR and TLSTR in HV correction using DCMO were not significantly different except for post-operative limitation of motion of the first MTPJ and hallux varus tendency. Different precautions should be taken into account when choosing the type of lateral soft tissue release due to possible complications associated with each technique.