The Differences between Fixation Devices for Proximal Chevron Osteotomy in Hallux Valgus Surgery

Kim, Taik Seon; Kang, Kyu Bok; Kang, Jong Woo; Kim, Hak Jun

Abstract

PURPOSE
The authors evaluated the differences between K-wires and Bold screw for fixing the proximal metatarsal chevron osteotomy of moderate and severe hallux valgus.
MATERIALS AND METHODS
There were 59 patients (81 feet) who were moderate and severe degree hallux valgus according to the classification of Mann. They all got the proximal chevron osteotomy when correcting the deformity. All patients were followed up at least 6 months. We divided the patients into 2 groups, K-wires fixed group as A, Bold screw fixed group as B. Group A were 42 patients (63 feet) and Group B were 18 patients (19 feet). Among the Group B, 2 feet who were failed to fix the oetotomy site with Bold screw, were fixed with K-wires during operation. We measured the AOFAS score preoperatively, postoperatively and at final follow-up, VAS score at 2 weeks after the operation. Also preoperative, postoperative and follow-up hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured for each patients.
RESULTS
Mean follow up period was 1.34 year (range: 6 months-6.16 years). Mean VAS score of group A was 3.21+/-1.7 and group B 1.76+/-1.0. Preoperative mean AOFAS score of group A was 45.61+/-8.3, group B 44.41+/-8.9, the final mean score of group A was 88.87+/-8.3 and group B 92.47+/-4.4. Preoperative mean HVA was 30.82+/-6.6 degrees in group A and 32.88+/-14.5 degrees in group B, the final mean angle of group A was 14.89+/-8.3 degrees and group B 17+/-4.4 degrees. The preoperative mean IMA of group A was 13.69+/-3.6 degrees and group B 12.35+/-5.2, the final mean angle of group A was 9.26+/-3.6 degrees and group B 12.35+/-5.8 degrees.
CONCLUSION
There were no statistical differences in radiologic and clinical results (p>0.05) but, group B exceeded group A in VAS score (p=0.0007) and had no statistical significance in terms of reduction angle loss (p=0.06). Early returning to normal life activity may be possible for patients using Bold screws.