Treatment for Hallux Valgus with Chevron Metatarsal Osteotomy in Patients over 60 Years Old

Jeong, Bi O; Lee, Sang Hyeon

Abstract

PURPOSE
To treat hallux valgus in old age patients with chevron metatarsal osteotomy and to see the subsequent clinical and radiological outcomes.
MATERIALS AND METHODS
23 cases of 18 hallux valgus patients of age 60 years or older who received proximal or distal corrective osteotomy from April 2007 to August 2009 and were followed up for at least 1 year were included in the study. The mean age at operation was 65 years (range, 60~81 years), and the mean follow-up period was 2 years and 6 months (range, 1 year~3 years 6 months). Clinical outcome was assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) score, complications, satisfaction rate, as well as measurements and comparison of pre- and postoperative hallux valgus angles, the 1st~2nd intermetatarsal angle, and the position of hallucal medial sesamoid bone.
RESULTS
The AOFAS score was improved from preoperative average of 35.1 (range, 13-47) to average 85.1 at last follow-up (range, 75-100). Patients were satisfied about the operation in 21 cases (91.3%). Preoperative hallux valgus angle was 31.7degrees on average (range, 19.1degrees-48.9degrees), and 4.9degrees on average at last follow-up (range, 0.3degrees-21.2degrees). The 1st~2nd intermetatarsal angle was 14.4degrees on average (range, 8.7degrees-25.7degrees) and 3.1degrees on average at last follow-up (range, 0.6degrees-7.5degrees). The hallucal medial sesamoid bone position was improved from preoperative average 3.5 (range, 3-4) to postoperative average 1.0 (range, 0-2).
CONCLUSION
Proximal and distal metatarsal osteotomy treatment yielded good clinical and radiological outcomes in old age hallux valgus patients.