title: The risk of avascular necrosis following chevron osteotomy: a prospective study using bone scintigraphy.
abstract: Controversy exists with regard to the effects of chevron osteotomy on blood supply and subsequent development of avascular necrosis (AVN) of the first metatarsal head. The aim of this study was to assess the incidence of avascular necrosis in our centre following chevron osteotomy for hallux valgus, using bone scintigraphy. Thirty nine patients who had a chevron osteotomy for treatment of hallux valgus were prospectively studied. Mean follow-up was 14 months. Bone scintigraphy was used to assess metatarsal head perfusion at an average 8.5 weeks post operatively. Three patients (7.7%) showed abnormal bone scan around the metatarsal head. Further evaluation of these patients did not show any sign of AVN. We conclude there appears to be a risk of circulatory disturbance to the metatarsal head following chevron osteotomy of the first metarsal (7.7% in this study); however this does not translate into clinically significant AVN.
authors.affiliation: Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom. shariffstays@yahoo.com
authors.forename: Raheel
authors.initials: R
authors.lastname: Shariff
authors.forename: Fahad
authors.initials: F
authors.lastname: Attar
authors.forename: Donald
authors.initials: D
authors.lastname: Osarumwene
authors.forename: Rehan
authors.initials: R
authors.lastname: Siddique
authors.forename: Gulam Dastagir
authors.initials: GD
authors.lastname: Attar
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008684:Metatarsus / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010020:Osteonecrosis / Q000453:epidemiology*; D010027:Osteotomy / Q000009:adverse effects*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D011877:Radionuclide Imaging; D016896:Treatment Outcome