STIMULATION OF BONE HEALING BY ULTRASOUND AFTER CHEVRON OSTEOTOMY FOR HALLUX VALGUS

Abstract

Chevron osteotomy for correction of symptomatic hallux valgus deformity is a widely accepted method. Full weight bearing in regular shoes is not recommended before six weeks after surgery. Low intensity pulsed ultrasound is known to stimulate bone formation leading to more stable callus and faster bony fusion. We performed a randomized, placebo-controlled, double-blinded study on 44 patients (52 feet) who underwent chevron osteotomy to evaluate the influence of daily transcutaneous low intensity pulsed ultrasound (LIPUS) treatment at the site of osteotomy. Follow up at six weeks and one year was done with plain dorsoplantar radiographs, halluxrmetatarsophalangeal-interphalangeal scale and a questionnaire on patient satisfaction. There was no statistical difference concerning all pre- and postoperative clinical features, patient satisfaction and all radiographic measurements (hallux valgus angle, intermetatarsal angle, sesamoid index, metatarsal index) except for the first distal metatarsal articular angle (DMAA). The DMAA showed statistical significant (p=0,046) relapse in the placebo group comparing intraoperative radiographs after correction and fixation (5,2 degrees) and at six weeks follow up (10,6 degrees). Despite potential impact of LIPUS on bone formation we found no clinical evidence for its influence on outcome six weeks and one year after chevron osteotomy for correction of hallux valgus deformity.