No midterm benefit from low intensity pulsed ultrasound after chevron osteotomy for hallux valgus.
Chevron osteotomy is a widely accepted method for correction of symptomatic hallux valgus deformity. Full weight bearing in regular shoes is not recommended before 6 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 participants (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 6 weeks and 1 year included plain dorsoplantar radiographs, hallux-metatarsophalangeal-interphalangeal scale and a questionnaire on patient satisfaction. There was no statistical difference in any pre- or postoperative clinical features, patient satisfaction or radiographic measurements (hallux valgus angle, intermetatarsal angle, sesamoid index and metatarsal index) except for the first distal metatarsal articular angle (DMAA). The DMAA showed statistically significant (p = 0.046) relapse in the placebo group upon comparison of intraoperative radiographs after correction and fixation (5.2 degrees) and at the 6-week follow-up (10.6 degrees). Despite potential impact of LIPUS on bone formation, we found no evidence of an influence on outcome 6 weeks and 1 year after chevron osteotomy for correction of hallux valgus deformity.
Zacherl
Max
M
Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria. max_zacherl@hotmail.com
Gruber
Gerald
G
Radl
Roman
R
Rehak
Peter H
PH
Windhager
Reinhard
R
D000328:Adult; D000368:Aged; D001864:Bone Wires; D001915:Braces; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011184:Postoperative Period; D011859:Radiography; D020127:Recovery of Function; D018709:Statistics, Nonparametric; D017211:Treatment Failure; D014464:Ultrasonic Therapy / Q000379:methods*