title: Comparison of the Modified McBride Procedure and the Distal Chevron Osteotomy for Mild to Moderate Hallux Valgus.
abstract: Distal metatarsal osteotomy and the modified McBride procedure have each been used for the treatment of mild to moderate hallux valgus. However, few studies have compared the results of these 2 procedures for mild to moderate hallux valgus. The purpose of the present study was to compare the results of distal chevron osteotomy and the modified McBride procedure for treatment of mild to moderate hallux valgus according to the severity of the deformity. We analyzed the data from 45 patients (49.5%; 48 feet [49.0%]), who had undergone an isolated modified McBride procedure (McBride group), and 46 patients (50.5%; 50 feet [51.0%]), who had a distal chevron osteotomy (chevron group). We subdivided each group into those with mild and moderate deformity and compared the clinical and radiologic outcomes between the groups in relation to the severity of the deformity. The improvements in the American Orthopaedic Foot and Ankle Society scale score and the visual analog scale for pain were significantly better for the chevron group for both mild and moderate deformity. The chevron group experienced significantly greater correction in the hallux valgus angle and intermetatarsal angle for both mild and moderate deformity. The chevron group experienced a significantly greater decrease in the grade of sesamoid displacement for patients with moderate deformity. The McBride group had a greater risk of recurrence than did the chevron group for moderate deformity (odds ratio 14.00, 95% confidence interval 3.91 to 50.06, p < .001). The results of the present study have demonstrated the superiority of the distal chevron osteotomy over the modified McBride procedure for mild to moderate deformity. For patients with moderate deformity, the McBride group had a greater risk of hallux valgus recurrence than did the distal chevron group. Therefore, we recommend distal chevron osteotomy rather than a modified McBride procedure for the treatment of mild and moderate hallux valgus.
authors.affiliation: Clinical Assistant Professor, Department of Orthopaedic Surgery, Korea University Ansan Hospital, Ansan-si, Korea.
authors.forename: Gi Won
authors.initials: GW
authors.lastname: Choi
authors.affiliation: Professor, Department of Orthopaedic Surgery, Korea University Guro Hospital, Seoul, Korea. Electronic address: hjunkimos@gmail.com.
authors.forename: Hak Jun
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Orthopaedic Surgeon, Department of Orthopaedic Surgery, Veterans Health Service Medical Center, Seoul, Korea.
authors.forename: Taik Seon
authors.initials: TS
authors.lastname: Kim
authors.affiliation: Orthopaedic Surgeon, Department of Orthopaedic Surgery, Korea University Guro Hospital.
authors.forename: Sung Kwang
authors.initials: SK
authors.lastname: Chun
authors.affiliation: Orthopaedic Surgeon, Department of Orthopaedic Surgery, Korea University Guro Hospital.
authors.forename: Tae Wan
authors.initials: TW
authors.lastname: Kim
authors.affiliation: Orthopaedic Surgery Resident, Department of Orthopaedic Surgery, Veterans Health Service Medical Center, Seoul, Korea.
authors.forename: Yong In
authors.initials: YI
authors.lastname: Lee
authors.affiliation: Orthopaedic Surgery Resident, Department of Orthopaedic Surgery, Veterans Health Service Medical Center, Seoul, Korea.
authors.forename: Kyoung Ho
authors.initials: KH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000145:classification / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011859:Radiography / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology*; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
keywords: bunionectomy; first ray; metatarsal; proximal phalanx; soft tissue procedure