Distal Chevron Osteotomy for Moderate to Severe Hallux Valgus Deformity in Patients Aged 50 or Older

Won Joon Yoo; Moon Sang Chung; Goo Hyun Baek; Chang Hun Yu; Hyuk Ju Moon

doi:10.4055/jkoa.2008.43.4.445

Journal List > J Korean Orthop Assoc > v.43(4) > 1012808

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Yoo, Chung, Baek, Yu, and Moon: Distal Chevron Osteotomy for Moderate to Severe Hallux Valgus Deformity in Patients Aged 50 or Older

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2008; 43(4): 445-450.

Published online: 31 August 2008

DOI: https://doi.org/10.4055/jkoa.2008.43.4.445

Distal Chevron Osteotomy for Moderate to Severe Hallux Valgus Deformity in Patients Aged 50 or Older

Won Joon Yoo, M.D., Moon Sang Chung, M.D., Goo Hyun Baek, M.D., Chang Hun Yu, M.D., Hyuk Ju Moon, M.D.

Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.

Address reprint requests to: Won Joon Yoo, M.D. Department of Orthopedic Surgery, Seoul National University Hospital, 28, Yongon-dong, Chongno-gu, Seoul 110-744, Korea. Tel: +82.2-2072-1966, Fax: +82.2-745-3367, yoowj@snu.ac.kr

Abstract

Purpose

The purpose of this study was to analyze the clinical and radiological results of distal chevron osteotomy in patients aged 50 and older with moderate-to-severe hallux valgus.

Materials and Methods

The authors reviewed the medical records and radiographs of 19 patients (26 feet). Average age at time of surgery was 58 years and the mean follow-up period was 3 years and 1 month. For radiological evaluation, we analyzed changes in hallux valgus angles and 1^st-2^nd intermetatarsal angles after index operations. Clinical results were assessed with respect to pain, activities of daily living, and shoe-wear.

Results

Hallux valgus angles and 1^st-2^nd intermetatarsal angles improved, but considerable correction loss occurred with time. This correction loss was found to be significantly correlated with preoperative subluxation of the 1st metatarsophalangeal joint and the 1^st-2^nd intermetatarsal angle. Clinically, remarkable improvements were achieved in terms of pain and level of activity, but most patients (except 4) still wore comfortable shoes rather than hard shoes at latest follow-ups.

Conclusion

Distal chevron osteotomy is beneficial for patients aged 50 and older with moderate-to-severe hallux valgus deformity, but correction loss may occur in patients with marked subluxation of the 1^st metatarsophalangeal joint or a severe 1^st-2^nd intermetatarsal angle.

Keywords: Hallux valgus, Distal chevron osteotomy

Figures and Tables

Fig. 1

A 66-year old female with hallux valgus foot deformity. (A) Preoperatively, the 1st-2nd intermetatarsal angle was 16° and 1st metatarsophalangeal joint subluxation was 12%. (B) The deformity was corrected by distal chevron osteotomy. Postoperatively, the 1st-2nd intermetatarsal angle was 4°. (C) However, 10 years after the operation, the hallux valgus angle had increased to 32°, and the 1st-2nd intermetatarsal angle to 10°, and the metatarsophalangeal joint was subluxated. Nevertheless, the patient reported only mild discomfort.

Table 1

Changes in Radiological Indices

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