title: Treatment of moderate hallux valgus by percutaneous, extra-articular reverse-L Chevron (PERC) osteotomy.
abstract: OBJECTIVE
  The aim of this study was to report a single surgeon series of consecutive patients with moderate hallux valgus managed with a percutaneous extra-articular reverse-L chevron (PERC) osteotomy.
  
  
  METHODS
  A total of 38 patients underwent 45 procedures. There were 35 women and three men. The mean age of the patients was 48 years (17 to 69). An additional percutaneous Akin osteotomy was performed in 37 feet and percutaneous lateral capsular release was performed in 22 feet. Clinical and radiological assessments included the type of forefoot, range of movement, the American Orthopedic Foot and Ankle (AOFAS) score, a subjective rating and radiological parameters. The mean follow-up was 59.1 months (45.9 to 75.2). No patients were lost to follow-up.
  
  
  RESULTS
  The mean AOFAS score increased from 62.5 (30 to 80) pre-operatively to 97.1 (75 to 100) post-operatively. A total of 37 patients (97%) were satisfied. At the last follow up there was a statistically significant decrease in the hallux valgus angle, the intermetatarsal angle and the proximal articular set angle. The range of movement of the first metatarsophalangeal joint improved significantly.. There was more improvement in the range of movement in patients who had fixation of the osteotomy of the proximal phalanx.
  
  
  CONCLUSIONS
  Preliminary results of this percutaneous approach are promising. This technique is reliable and reproducible. Its main asset is that it maintains an excellent range of movement.
  
  
  CONCLUSIONS
  The PERC osteotomy procedure is an effective approach for surgical management of moderate hallux valgus which combines the benefits of percutaneous surgery with the versatility of the chevron osteotomy whilst maintaining excellent first MTPJ range of motion.
authors.affiliation: Bordeaux University Hospital, Centre Médico-chirurgical Universitaire du Pied, place Amélie Raba-Léon, Bordeaux, France.
authors.forename: J
authors.initials: J
authors.lastname: Lucas y Hernandez
authors.affiliation: University of Barcelona, Human and Embriology Unit, Dept of experimental pathology and therapeutics, University of Barcelona, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Golanó
authors.affiliation: Western Health, Western Health, Gordon Street, Footscray, Victoria, 3011, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Roshan-Zamir
authors.affiliation: Robert Picqué Military Hospital, 351 Route de Toulouse, 33140 Villenave-d'Ornon, France.
authors.forename: V
authors.initials: V
authors.lastname: Darcel
authors.affiliation: Bordeaux University Hospital, Centre Médico-chirurgical Universitaire du Pied, place Amélie Raba-Léon, Bordeaux, France.
authors.forename: D
authors.initials: D
authors.lastname: Chauveaux
authors.affiliation: Clinique Geoffroy St Hilaire, 59 rue Geoffroy St Hilaire, Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Laffenêtre
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000503:physiopathology; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D055815:Young Adult
keywords: Percutaneous osteotomy; chevron osteotomy; hallux valgus; reverse-L; PERC