title: Comparison of distal chevron osteotomy with and without lateral soft tissue release for the treatment of hallux valgus.
abstract: BACKGROUND
  A lateral soft tissue release is often performed with distal chevron osteotomy for the correction of hallux valgus deformities. However, many complications of lateral soft tissue release have been reported. To define the necessity of lateral soft tissue release, the authors compared the clinical and radiographic results of distal chevron osteotomy with and without it.
  
  
  METHODS
  86 consecutive patients (152 feet) were enrolled in this prospective study. In Group A, 45 patients (74 feet) underwent a chevron osteotomy with lateral soft tissue release. In Group B, 41 patients (78 feet) underwent a chevron osteotomy without it. Mean followup was 1.7 years and 2.1 years, respectively. The hallux valgus angle (HVA) and intermetatarsal angle (IMA), and AOFAS score were measured preoperatively, and 1-year followup postoperatively and complications were evaluated.
  
  
  RESULTS
  The change in HVA, IMA and AOFAS score were insignificant (p > 0.05) between Group A and Group B, however, the range of motion of the first metatarsophalangeal joint was significantly less in Group A (p < 0.05). Complications of digital neuritis and cosmetically dissatisfied scarring of the dorsal web space were seen only in Group A. No cases had avascular necrosis of the metatarsal head, malunion or nonunion.
  
  
  CONCLUSIONS
  Lateral soft tissue release may not be needed for mild or moderate hallux valgus deformities which may prevent decreased range of motion of the first metatarsophalangeal joint, neuritis of dorsal or plantar lateral digital nerve and cosmetic dissatisfaction of a dorsal scar.
authors.affiliation: Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, 505 Ban Po-Dong, Seoul, Korea.
authors.forename: Ho-Jin
authors.initials: HJ
authors.lastname: Lee
authors.forename: Jin-Wha
authors.initials: JW
authors.lastname: Chung
authors.forename: In-Tak
authors.initials: IT
authors.lastname: Chu
authors.forename: Yoon-Chung
authors.initials: YC
authors.lastname: Kim
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D013710:Tendons / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult