Prospective Randomized Study of Chevron Osteotomy Versus Mitchell’s Osteotomy in Hallux Valgus

Buciuto, Robert

doi:10.1177/1071100714550647

Cited by 22 publications

(16 citation statements)

References 27 publications

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“…The rate of transfer metatarsalgia was probably underreported due to incomplete documentation (8,9). The rate of 11.6% undercorrection found in the present study corresponds with rates reported, albeit with varying definitions and periods of followup, in the literature.…”

supporting

confidence: 83%

“…The corrections of IMA were a little better than those quoted in literature, 6.1 versus the mean of 5.3 degrees by the review of Smith et al (7) Other results of angular correction were similar to those reported in the recent literature. (6,8,14,15,25) However, limited patient numbers, different measurement methods, and divergent indications for the chevron complicate direct comparisons between those studies and our project. Another limitation is the amount of loss-to-follow up leading to a final response rate of those who filled in the FAOS of 60%.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes in chevron osteotomy for Hallux Valgus in a large cohort

et al. 2016

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Clinical and radiological related outcomes have been reported for Chevron osteotomy as correction for mild to moderate hallux valgus, but only for relatively small patient series. Moreover, evaluation of the patient's point of view has mostly been conducted by means of more physician-based outcome measures. The goal of this study was to evaluate the effect of the Chevron osteotomy for hallux valgus on patients' daily lives using the Foot and Ankle Outcome Score (FAOS) as a validated and a hallux valgus specific patient reported outcome measure (PROM). Secondary outcome measures were radiological correction, complication rate, and re-operations. All 438 Chevron procedures (336 patients), at two surgical hospital sites in the period between January 2010 and October 2014, were retrospectively evaluated with a follow-up of at least 6 months. Patients were invited to fill in a cross-sectional online FAOS. For the FAOS, a total response of 60% was achieved. The FAOS ranged between 71 and 88 with a follow-up of on average 36 months. Patients with an undercorrection of their hallux valgus (11.6% of the procedures) scored significantly lower on three subscales of the FAOS (range between 61 and 77 versus 72-84). Patients who had a reoperation (12.6% of the procedures) also scored significantly lower on four subscales: 58-100 versus 73-89. Postoperative radiological measurements improved significantly with a mean difference of 6.1 (5.9; 6.4) degrees for the intermetatarsal angle and 13.7 (13.0; 14.5) degrees for the hallux valgus angle. In this large study cohort, Chevron osteotomy for hallux valgus offers good PROM scores on FAOS. These scores were significantly lower in patients with radiological undercorrection or with a reoperation. Results of the FAOS appear to modulate with physician based outcomes and therapeutic incidents. Improvement of outcome may therefore well be possible by increased attention on these surgical details.

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confidence: 83%

Section: Discussionmentioning

confidence: 99%

Outcomes in chevron osteotomy for Hallux Valgus in a large cohort

et al. 2016

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“…In another study, by Buciuto, 120 patients were randomized to either chevron osteotomy or Mitchell osteotomy treatment groups 35 . The authors found that patients in the chevron osteotomy group had significantly higher AOFAS scores, fewer postoperative complications (e.g., transfer metatarsalgia), higher patient satisfaction, and fewer missed work days compared with the Mitchell osteotomy group.…”

Section: Hallux Valgusmentioning

confidence: 99%

What’s New in Foot and Ankle Surgery

Yeranosian

2016

The Journal of Bone and Joint Surgery

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“…The shortening, dorsiflexion, and elevation of the first metatarsal, which shift the first metatarsal head toward a more dorsal position, thereby transferring weight to the second metatarsal, have been recognized by many foot surgeons as a cause of metatarsalgia and poor surgical results. 5,6,32 The metatarsalgia caused by the elevation of the first metatarsal head had been reported to be one of the most frequent complications in DLMO or similar minimally invasive distal metatarsal osteotomies. 19,45 In the present research, postoperative metatarsalgia occurred in 10.0%, although the rate is not high compared with other procedures, 5,17 and the clinical outcome during the short follow-up period was acceptable.…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Analysis of the First Metatarsal Bone in Minimally Invasive Distal Linear Metatarsal Osteotomy for Hallux Valgus

et al. 2019

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Background: Modified Bösch osteotomy (distal linear metatarsal osteotomy [DLMO]) is one of the minimally invasive correctional surgeries for hallux valgus. The 3-dimensional correctional angles and distances of the first metatarsal bone in DLMO have not been clarified. The purpose of this study was to analyze the 3-dimensional postoperative morphological changes of the first metatarsal bone in DLMO. Methods: Twenty patients (30 feet) who underwent DLMO were enrolled. Preoperative plain radiographs and computed tomography (CT) scans of the feet were examined. Postoperative radiographs and CT scans were also obtained after bone union. The surface data of the pre- and postoperative first metatarsals were reconstructed from the CT data. The positions of the distal ends of the first metatarsals described with respect to the proximal ends were calculated using CT surface-matching technique. Results: The distal end of the first metatarsal after DLMO was significantly supinated (10.2 ± 6.0 degrees, P < .001), adducted (6.0 ± 11.8 degrees, P = .004), dorsiflexed (11.1 ± 10.9, P < .001), shortened (7.4 ± 2.5 mm, P < .001), elevated (2.3 ± 3.1 mm, P = .001), and laterally shifted (8.2 ± 3.0 mm, P < .001) compared to the preoperative metatarsal distal end. Supination correction demonstrated a significant correlation with adduction correction ( r = 0.659, P < .001) on correlation analyses between these parameters. Conclusion: The 3-dimensional corrections of the first metatarsal bone after DLMO were evaluated. Pronation and abduction were successfully corrected. Furthermore, adduction correction might be an important factor affecting correction of pronation. Level of Evidence: Level IV, retrospective case series.

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Prospective Randomized Study of Chevron Osteotomy Versus Mitchell’s Osteotomy in Hallux Valgus

Abstract: Level I, prospective randomized study.

Cited by 22 publications

References 27 publications

Outcomes in chevron osteotomy for Hallux Valgus in a large cohort

Outcomes in chevron osteotomy for Hallux Valgus in a large cohort

What’s New in Foot and Ankle Surgery

Three-Dimensional Analysis of the First Metatarsal Bone in Minimally Invasive Distal Linear Metatarsal Osteotomy for Hallux Valgus

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