Abstract
Introduction
Symptomatic hallux valgus is a common clinical problem, current trends is towards minimally invasive procedures. The goal of this study is to evaluate the outcome of minimally invasive chevron ostoetomy, comparing it with a matched group who had open chevron osteotomy.
Methods
Prospective study, 54 patients. MIS group 25 patients between October 2009 and November 2010. Open group 29 patients between Feb 2008 and October 2010. Inclusion criteria included, mild to moderate hallux valgus, no previous history of foot surgery, no history of inflammatory arthritis, or MTPJ arthritis. All the operations were performed by the senior author. Functional outcome and pain were evaluated using pre and post operative Manchester Oxford Foot and ankle questionnaire (MOXFQ). IMA and HVA, avascular necrosis and union were assessed. Complications and satisfaction were recorded.
Results
The MIS group with mean age at operation of 55, showed significant improvement in all the domains of the MOXFQ. Walking (p <0.018), foot pain (p = <0.013), social interaction (p = <0.001). The mean HVA and IMA corrections were 11.8° and 6.3°, (p < 0.001). The open group with mean age at operation of 55 years showed significant improvement in all domains of the MOXFQ, walking (p = <0.0001), foot pain (p = <0.002), social interaction (p = <0.0001). The HVA and IMA corrections were 10.5 and 5.9 degrees respectively (p = <0.001). The improvement in MOXFQ and HVA and IMA corrections were not statistically significant between the MIS and open groups.
Discussion and Conclusion
Our results showed that the MIS chevron osteotomy is an effective procedure with minimal complications and satisfactory functional outcome, comparable to the open standard chevron osteotomy. Larger sample size is required to confirm our findings.
