New Modification of Chevron Osteotomy in the Treatment of Hallux Valgus

Abstract

BACKGROUND:The Corless original chevron osteotomy is a 60 degree V shaped cut which had been described in1976 to address some of the drawbacks in Mitchell's procedure, several modifications since therehad been added both to extend the indications and to improve the stability of the cheveronosteotomy. In our study, we used the 90 degrees angle cut but kept the original Corless V shapedosteotomy in order to retain the stability.OBJECTIVE:To evaluate the mechanical and the clinical results of these modifications.PATIENTS AND METHODS:From January 2016 until June 2018, 15 patients (16 feet) have undergone new modification ofchevron osteotomy in medical city teaching hospitals, their ages were (25-50) year, the medianage±SD was (40±8.3), 2 male (3 feet), and 13 female, the patients included in this study haveintermetatarsal angles 12-20 and hallux valgus angle 23-46 degree all of them complaining of painor bursitis at the bunion site or discomfort in shoe wear, and followed clinically and radiologicallyfor at least 1 year.RESULTS:The 15 patients included in this study have completed at least 6 months of follow up, the point atwhich the final assessment was done, two of them were male (3 feet )(13.3%) their ages (43,45 y)median 44.0 ± 1.4y , and 13 female (86.7%) their age range (23-50y) the median 38.0 ± 8.7y.Significant improvements were noted in HVA (P- value 9.7x10-12 and IMA (P-value 1.6x10₋ 10)measurements, also similar improvement were obtained about the functional outcome represented bythe AOFAS score results (P-value 6.4 x 10-9).CONCLUSION:Modified chevron osteotomy was useful and safe to address mild to moderately severe cases ofhallux valgus, our new modification render it more stable with a high union rate.