Clinical Outcomes of Proximal Opening-Wedge Osteotomy and Distal Chevron Osteotomy in the Treatment of Moderate Hallux Valgus Deformity

Abstract

Introduction: Hallux valgus (HV) deformity is a condition with gradually increasing prevalence, often accompanied by cosmetic deformity. The change in pain and functional levels of patients after surgery directly affects the clinical outcomes in moderate hallux valgus deformities. Aim: The aim of this study was to compare the clinical outcomes of proximal opening-wedge osteotomy and distal chevron osteotomy in the treatment of moderate hallux valgus deformity. Materials and Methods: 37 patients aged between 55 and 65, who were diagnosed with moderate hallux valgus deformity between March 2015 and December 2017 in Ankara Yıldırım Beyazit University YenimahalleTraining and Research Hospital were enrolled in this study. Patients who underwent proximal opening-wedge osteotomy (POWO) were assigned to Group 1 (n=19) and patients who underwent distal chevron osteotomy (DCO) were assigned to Group 2 (n=18). There was no difference between the groups in terms of age, duration of follow-up, demographic and radiological parameters. Visual Analogue Scale (VAS) and American Orthopedic Foot and Ankle Score (AOFAS) systems were used to compare the preoperative period with months 3, 6 and 12. Results: There was a significant difference between the two groups in terms of VAS and AOFAS scores at months 3 and 6 in favor of Group 2 (p<0.001). According to the follow-up at month 12, the change in VAS (p=0.518) and AOFAS (p=0.119) measurements was not statistically significant for any of the groups. Both groups exhibited a statistically significant increase in the scores at months 3 and 6 as compared to the preoperative period. Conclusion: Proximal opening-wedge osteotomy was found to be more effective than distal chevron osteotomy in terms of short-term pain and functional scores in the treatment of moderate hallux valgus deformity. On the other hand, it was seen in follow-ups that both methods alleviated pain and provided similar improvement from the functional aspect.