Short-term results of minimally invasive Chevron osteotomy with lateral soft tissue release in treating mild to moderate hallux valgus

Abstract

To explore short-term results of minimally invasive Chevron osteotomy with lateral soft tissue release in treating mild to moderate hallux valgus. Sixty patients (80 feet) with mild to moderate hallux valgus treated with minimally invasive Chevron osteotomy with lateral soft tissue release from January 2019 to December 2021 were retrospectively analyzed. Among them, there were 5 males (6 feet) and 62 females (74 feet), aged from 20 to 60 years old with an average of (47.2±9.7) years old;54 patients (64 feet) with mild hallux valgus, and 13 patients(16 feet) with moderate hallux valgus. Hallux valugs angle(HVA), Ⅰ-Ⅱ intermetatarsal anlge(Ⅰ-Ⅱ IMA), distal metatarsal articular angle(DMAA)and sesamoid Hardy score were compared before and after operation, and American Orthopaedic Foot and Ankle Society's Hallux Metatarsophalangeal- Interphalangeal (AOFAS Hallux MTP-IP) scale was used to evaluate clinical effects. Sixty-seven patients (80 feet) were followed-up from 6 to 23 months with an average of (13.7±6.5) months. Preopertive HVA, Ⅰ-Ⅱ IMA, DMAA, sesamoid Hardy score and AOFAS Hallux MTP-IP were (27.5±7.0)°, (17.4±4.1)°, (11.4±3.8)°, (4.9±2.6) and (58.2±9.1), respectively;while at the final follow up were(8.3±4.8)°, (6.9±3.0)°, (3.9±2.4)°, (2.7±1.1) and(91.3±2.2);and there were statistical differences between pre-operation and the latest follow-up(P<0.05). There were differences in preopertaive imaging indexes and AOFAS Hallux MTP-IP between 64 mild and 16 moderate hallux valgus feet(P<0.05);while no difference in above indexes at the final follow-up(P>0.05);from the view of degree of improvement, HVA, Ⅰ-Ⅱ IMA, sesamoid Hardy score and AOFAS Hallux MTP-IP in moderate hallux valgus were better than that of in mild hallux valgus(P<0.05). Four patients occurred redness and swelling around incision on the osteotomy site, and cured by local dressing change and oral antibiotics. Minimally invasive Chevron osteotomy combined with lateral soft tissue release has advantages of correction and functional improvement for mild to moderate hallux valgus.