title: [Modified chevron osteotomy with lateral release and screw fixation for treatment of severe hallux deformity].
abstract: BACKGROUND
  This prospective study examined the clinical and radiological results of the Chevron osteotomy with screw fixation and distal soft tissue release up to an intermetatarsal angle of 19°. Furthermore, the results are presented for patients over the age of 70 years, and whether or not there is a higher complication rate.
  
  
  METHODS
  86 feet of patients between 23 and 81 years were included in the study. Apart from the overall group, a group with an intermetatarsal angle of 16° to 19° and a group of patients over 70 years old were eavaluated. They were evaluated preoperatively and at follow-up after an average of 3.3 years according to the American Orthopaedic Foot and Ankle Society score.
  
  
  RESULTS
  The AOFAS score showed a significant improvement from 55 points preoperatively to 90 points at follow-up. The preoperative hallux valgus angle decreased significantly from 32° to 5° and the preoperative intermetatarsal angle decreased from 14° to 6°. Patient satisfaction in the overall group was rated in 92 % as excellent or good. Also, the patient group with 16° to 19° angles and the patients over 70 years showed a significant improvement of clinical and radiological parameters. The complication rate was very low in all groups.
  
  
  CONCLUSIONS
  The results show that the Chevron osteotomy is a very good surgical technique with few complications for the correction of splay foot with hallux valgus deformity. We showed that by using the modified technique with a long plantar arm, an excessive soft tissue release and screw fixation, the indication can be extended up to an intermetatarsal angle of 19° when using screw fixation. Furthermore the patients over 70 years of age showed a significant improvement of clinical and radiological parameters without serious complications such as avascular necrosis or dislocation of the metatarsal head.
authors.affiliation: Abteilung für Orthopädie, Klinikum Wels-Grieskirchen, Wels, Österreich. stefanhofstaetter@gmx.at
authors.forename: S G
authors.initials: SG
authors.lastname: Hofstaetter
authors.forename: R
authors.initials: R
authors.lastname: Schuh
authors.forename: K
authors.initials: K
authors.lastname: Trieb
authors.forename: H J
authors.initials: HJ
authors.lastname: Trnka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D003131:Combined Modality Therapy; D005260:Female; D006215:Hallux Valgus / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation* / Q000379:methods*; D011859:Radiography; D016896:Treatment Outcome; D055815:Young Adult