J Korean Foot Ankle Soc.  2010 Jun;14(1):16-20.

Treatment of Severe Hallux Valgus Deformity with Proximal Reverse Chevron Metatarsal Osteotomy and Akin Osteotomy

• Jung HG
• Oh JH
• Kim TH
• Park JY
• Kang MS

Abstract

PURPOSE
This study analyzed the clinical and radiographic outcome of the severe hallux valgus corrected with proximal reverse chevron metatarsal osteotomy and Akin osteotomy.
MATERIALS AND METHODS
The study was based on 18 feet (15 patients) of severe hallux valgus (hallux valgus angle> or =40degrees or intermetatarsal angle> or =18degrees) treated with proximal reverse chevron metatarsal osteotomy and followed for more than 1 year. Akin osteotmy was added in 72% of the patients. Clinically preoperative and postoperative AOFAS Hallux Metatarsophalangeal - interphalangeal score, VAS pain score and satisfaction after the surgery were analyzed. Radiologically hallux valgus angle, hallux valgus interphalangeal angle, the intermetatarsal angle and sesamoid position before and after the operation were analyzed.
RESULTS
AOFAS Hallux Metatarsophalangeal - interphalangeal score improved from 54.5 (25-78) to 87.7 (70-100) and VAS pain score decreased from 6.0 (3-8) to postoperative 1.2 (0-5). Ninety-six percents of the patients were satisfied with results. Radiologically hallux valgus angle was decreased from 43.3degrees(31-58degrees) preoperatively to 6.8degrees (-8-27degrees) postoperatively. The intermetatarsal angle was decreased from 18.4degrees(11-24degrees) preoperatively to 5.3degrees (1-12degrees) postoperatively. The sesamoid subluxation was improved from 2.8+/-0.4 preoperatively to 0.4+/-0.6 postoperatively.
CONCLUSION
Proximal reverse chevron metatarsal osteotomy and lateral soft tissue release with additional Akin osteotomy is good treatment option for severe hallux valgus.

Keyword

Severe hallux valgus; Proximal reverse chevron metatarsal osteotomy; Akin osteotomy

MeSH Terms

Congenital Abnormalities
Foot
Hallux
Hallux Valgus
Humans
Metatarsal Bones
Osteotomy