Abstract
Introduction: Hallux valgus is a common foot deformity. A widely used method for correction of mild and moderate hallux valgus is a distal metatarsal (Chevron) osteotomy. The purpose of this study was to assess the results of a percutaneous chevron osteotomy two years after my first communication in Arcachon.
Patients and method: The operation is performed by one senior surgeon. The patient is placed in the supine position. The foot is allowed to overhang the end of the table. No tourniquet is used. The procedure is controlled by fluoroscopy. The chevron osteotomy is undertaken with a Shannon burr of 12 mm and a 20 mm for the last case. The axis of translation is determined preoperatively and adapted to the foot: more or less plantar displacement of the metatarsal head, or, more or less shortening of the metatarsal itself. The translation of the head is controlled by a temporary intramedullary K-wire inserted medially. The fixation is with an absorbable k-wire for one part and by screw for the other part. The medial exostosis is not systematically removed. The procedure is completed by an Akin osteotomy in 90%. A lateral release procedure is performed percutaneously.
Results: The mean age of the patients was 55 years at time of operation. At the follow-up of 3 months all patients are examined and X-Ray’s taken. The Kitaoka score increased from 45 to 89. The hallux valgus angle decreases from 37° to 10°. The metatarsus varus is 10°. Three patients need a new surgery for a secondary displacement. Our results are comparable to those published for open chevron osteotomy in terms of correction of the HV and intermetatarsal angles.
Correspondence should be addressed to: Mr Andrew H. N. Robinson, Editorial Secretary, Department of Trauma and Orthopaedics, BOX 37, Addenbrooke’s Hospital, Cambridge CB2 2QQ, England.
