Radiological Comparison between 60 degrees Distal Chevron Osteotomy and 40 degrees Distal Chevron Osteotomy in Hallux Valgus

Rha, Jong Deuk; Park, Hyun Soo; Lim, Chang Suk; Jang, Young Soo; Jeon, Yong Soo; Jin, Hyun Bae; Kim, Kyung Hun

Abstract

PURPOSE: We made a radiological comparison between 60 degrees distal Chevron osteotomy with short armed two parts and 40 degrees distal Chevron osteotomy with long armed one part performing operation in cases of hallux valgus angle of less than 40 degrees, intermetatarsal angle of less than 15 degrees.
MATERIALS AND METHODS
12 cases with 60 degrees distal Chevron osteotomy and 12 cases with 40 degrees distal Chevron osteotomy were selected from October 2000 to March 2005. We have analysed the hallux valgus angle, 1-2 intermetatarsal angle, metatarsal length, distal metartarsal articular angle and angulation at osteotomy site on lateral view in each radiological films taken at preoperative, postoperative and 3 months after operation presuming bone union. All cases were women, both sides were 9 cases and average age was 52.3 years old.
RESULTS
Data taken at preoperative, postoperative and 3 months follow up films in 60 degrees distal Chevron osteotomy were as follows; the hallux valgus angles were 32.1 degrees, 10.9 degrees, 13.8 degrees, the 1-2 intermetatarsal angles were 13.6 degrees, 8.5 degrees, 8.4 degrees, the metatarsal length were 60.6 mm, 58.8 mm, 58 mm, the distal metartarsal articular angles were 13 degrees, 6 degrees, 6.6 degrees and 3 cases were over 3 degrees angulation at lateral view. In 40 degrees distal Chevron osteotomy, the hallux valgus angles were 34.5 degrees, 11.6 degrees, 15.3 degrees, the 1-2 intermetatarsal angles were 12.7 degrees, 8.2 degrees, 7.8 degrees, the metatarsal length were 59.2 mm, 56.9 mm, 55.9 mm, the distal metartarsal articular angles were 12 degrees, 7.3 degrees, 7.3 degrees and there were no case with angulation over 3 degrees at lateral view.
CONCLUSION
In comparison between 60 degrees distal Chevron osteotomy and 40 degrees distal Chevron osteotomy measuring at postoperative and follow up, most of all data were similar, but 3 cases over 3 degrees angulation at lateral view happened in 60 degrees Chevron osteotomy. This result showed that 40 degrees distal Chevron osteotomy fixing with screws through long armed one part may have benefit than 60 degrees distal Chevron osteotomy fixing with K-wires through short armed two parts in making rigid fixation, even though there is a personal difference of technigue.