Abstract
Introduction There is no consensus on the superiority of either Chevron or Mitchell osteotomy in the treatment of hallux valgus. In the literature Chevron osteotomy is recommended for the mild and Mitchell’s for the moderate hallux valgus (HV) deformities. We reviewed outcomes of two of the most common distal first metatarsal osteotomies.
Aims To compare the results of Chevron vs Mitchell osteotomy in the treatment of HV.
To evaluate the co-relation between clinical outcome and radiological correction achieved after the two osteotomies.
Method We reviewed clinical notes and pre- and postoperative radiographs of a total of 111 operations including 61 Chevron and 50 Mitchell osteotomies in 90 patients.
We designed a patient-focused questionnaire to evaluate clinical outcomes that addressed the main functional outcomes concerning patients after bunion surgery. These included pain, usage of footwear postoperatively, cosmoses, development of transfer metatarsalgia and the repeatability of the procedure they had undergone. These questions were point based and a final clinical score was calculated for comparison with the radiological correction. This was also used as a measure of success of the procedure.
Conclusion There is a statistically significant radiological difference in HV angle correction and the loss of first metatarsal height as seen post-operatively between patients treated with Chevron and Mitchell osteotomies for HV correction (p=0.03 and p=0.0004 respectively). There is no statistically significant difference (p=0.6) in the clinical outcomes based on the newly designed patient-focused questionnaire with either Chevron or Mitchell osteotomies at a mean follow-up of 27 months post-operatively. Clinical outcome determined by patient-focused questionnaire remains the same in-spite of radiological differences noticed post-operatively between the two osteotomies.
Correspondence should be addressed to BOFSS, c/o Wrightington Wigan and Leigh NHS Trust, Hall Lane, Appley Bridge, Wigan, Lancashire WN7 9EP.
