Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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A Comparison of Proximal and Distal Chevron Osteotomy for the Correction of Severe Hallux Valgus Deformity

중증 무지외반증에서 원위 중족골 갈매기 절골술과 근위 중족골 갈매기 절골술의 결과 비교

  • Park, Hyung Seok (Department of Orthopaedic Surgery, College of Medicine, Chosun University) ;
  • Lee, Jun Young (Department of Orthopaedic Surgery, College of Medicine, Chosun University) ;
  • Ko, Kang Yeol (Department of Orthopaedic Surgery, College of Medicine, Chosun University) ;
  • Ryu, Jehong (Department of Orthopaedic Surgery, College of Medicine, Chosun University) ;
  • Lim, Jae Hwan (Department of Orthopaedic Surgery, College of Medicine, Chosun University)
  • 박형석 (조선대학교 의과대학 정형외과학교실) ;
  • 이준영 (조선대학교 의과대학 정형외과학교실) ;
  • 고강열 (조선대학교 의과대학 정형외과학교실) ;
  • 류제홍 (조선대학교 의과대학 정형외과학교실) ;
  • 임재환 (조선대학교 의과대학 정형외과학교실)
  • Received : 2020.04.20
  • Accepted : 2020.11.18
  • Published : 2020.12.15
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Abstract

Purpose: This study compared the results of proximal and distal chevron osteotomy in patients with severe hallux valgus. Several recent studies have shown that the indications for distal metatarsal osteotomy with a distal soft-tissue procedure could be extended to include severe hallux valgus. Materials and Methods: This study analyzed 127 severe hallux valgus surgeries. Of these, 76 patients (76 feet) were excluded for lack of adequate follow-up and additional procedures (Akin procedure), leaving 51 patients (51 feet) in the study. The mean age of the patients was 58 years (21~83 years), and the mean follow-up duration was 18 months (12~32 months). The patients were divided into two groups. Group 1 underwent distal chevron osteotomy, and group 2 underwent proximal chevron osteotomy performed sequentially by a single surgeon. The patients were interviewed for the American Orthopaedic Foot and Ankle Society (AOFAS) score before and one year after surgery. The anteroposterior weight-bearing radiography of the foot was taken before and one year after surgery. Results: There were no significant differences in pain and function after one year in either group. Both groups experienced significant pain reduction and an increase in the AOFAS score. Significant improvement of the hallux valgus and intermetatarsal angle corrections was observed in both groups, and the sesamoid position was similar in each group. More improvement in radiographic correction of intermetatarsal angle was noted in group 2. Both procedures gave similar good clinical and radiological outcomes. Conclusion: This study suggests that a distal chevron osteotomy with a distal soft-tissue procedure is as effective and reliable a means of correcting severe hallux valgus as a proximal chevron osteotomy with a distal soft-tissue procedure.

Keywords

Acknowledgement

This study was supported by research fund from Chosun University, 2019.

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