Surgical treatment of hallux valgus using chevron technique

Author(s): Ashraf Abd-Eldayem, Hossam Fekry and Nagy Fouda

Abstract: Background: The great toe is affected by many congenital and acquired conditions including hallux valgus. Hallux valgus was first reported in 1856. Most patients with hallux valgus are young females. High heel shoes are extrinsic factors which are important in the development of hallux valgus. More than 130 procedures have been described in the treatment of hallux valgus. The chevron osteotomy is one of the most widely used distal metatarsal osteotomies for the treatment of this deformity in adults. The idea of the Chevron osteotomy is that, it is a V shaped horizontally oriented with lateral displacement of the head of the first metatarsal accompanied with release and balancing of the soft tissue structure on both sides of the joint.
Patients and Methods: Study include 36 patients, all were females. The mean age was 35 years. All patients have symptomatic bilateral hallux valgus deformity. Pain was the primary reason for surgery. Study designed for comparison of results of Chevron’s osteotomy with fixation by 2 k-wires versus no fixation. Fifty percent of cases subjected for fixation and 50 percent with no fixation. No specific selection was performed.
Results: Evaluation of the results includes radiological and clinical observations. Assessment using the American Orthopaedic Foot and Ankle Society's hallux-metatarsophalangeal-interphalangeal scale was also done. Inter-metatarsal angle averaged 18° pre-operatively and 10° post-operatively, the corresponding values for hallux angle was 25° and 16° respectively. No complications of thrombophlebitis, non-union or avascular necrosis were recorded. Overall results show 94% as excellent or good results.
Conclusion: The Chevron osteotomy disclosed excellent relief of pain, good cosmetic correction and overall patient satisfaction. Stability and the technical ease make this procedure preferable for correction of moderate hallux valgus deformity.

DOI: https://doi.org/10.22271/ortho.2018.v4.i2e.44