title: Comparison of outcomes between proximal and distal chevron osteotomy, both with supplementary lateral soft-tissue release, for severe hallux valgus deformity: A prospective randomised controlled trial.
abstract: Severe hallux valgus deformity is conventionally treated with proximal metatarsal osteotomy. Distal metatarsal osteotomy with an associated soft-tissue procedure can also be used in moderate to severe deformity. We compared the clinical and radiological outcomes of proximal and distal chevron osteotomy in severe hallux valgus deformity with a soft-tissue release in both. A total of 110 consecutive female patients (110 feet) were included in a prospective randomised controlled study. A total of 56 patients underwent a proximal procedure and 54 a distal operation. The mean follow-up was 39 months (24 to 54) in the proximal group and 38 months (24 to 52) in the distal group. At follow-up the hallux valgus angle, intermetatarsal angle, distal metatarsal articular angle, tibial sesamoid position, American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal score, patient satisfaction level, and complications were similar in each group. Both methods showed significant post-operative improvement and high levels of patient satisfaction. Our results suggest that the distal chevron osteotomy with an associated distal soft-tissue procedure provides a satisfactory method for correcting severe hallux valgus deformity.
authors.affiliation: Chonnam National University Hospital and Medical School, Department of Orthopaedic Surgery, 42 Jebong-ro, Donggu, Gwang-ju City 501-757, Korea.
authors.forename: H-W
authors.initials: HW
authors.lastname: Park
authors.forename: K-B
authors.initials: KB
authors.lastname: Lee
authors.forename: J-Y
authors.initials: JY
authors.lastname: Chung
authors.forename: M-S
authors.initials: MS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult