title: Plate fixation for proximal chevron osteotomy has greater risk for hallux valgus recurrence than Kirschner wire fixation.
abstract: OBJECTIVE
  The purpose of this study was to compare the results of hallux valgus surgery between feet fixed with Kirschner wires and those fixed with a plate and screws.
  
  
  METHODS
  Between December 2008 and November 2009, 53 patients (62 feet) were treated with proximal chevron osteotomy and distal soft tissue procedure for symptomatic moderate to severe hallux valgus deformity. Thirty-four patients (41 feet) were stabilised with Kirschner wires (K-wire group) and 19 patients (21 feet) were stabilised with a locking plate (plate group). Clinical results were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score. Radiographic parameters were compared between these groups. Recurrence rate at the last follow-up was compared between the K-wire and plate groups.
  
  
  RESULTS
  Mean AOFAS score was lower in the plate group, however, the difference between the groups was not statistically significant in AOFAS score at the last follow-up. Hallux valgus angle and intermetatarsal angle were significantly larger in the plate group at the last follow-up. Mean 1-2 metatarsal (MT) distance on immediately postoperative radiographs was significant larger in the plate group. Four (9.8 %) of the 41 feet in the K-wire group and 7 (33.3 %) of the 21 feet in the plate group showed hallux valgus recurrence at the last follow-up. The plate group had a significantly higher risk of recurrence than the K-wire group.
  
  
  CONCLUSIONS
  Fixation of proximal chevron osteotomy using a plate and screws has a greater risk of hallux valgus recurrence than fixation using Kirschner wires.
authors: Department of Orthopaedic Surgery, Yeungnam University Hospital, Daegu, South Korea.
authors: Chul-Hyun
authors: CH
authors: Park
authors: Ji-Yong
authors: JY
authors: Ahn
authors: Yu-Mi
authors: YM
authors: Kim
authors: Woo-Chun
authors: WC
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D001863:Bone Screws; D001864:Bone Wires; D005260:Female; D005500:Follow-Up Studies; D006214:Hallux / Q000000981:diagnostic imaging / Q000601:surgery; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome