Treatment of Bunionette Deformity with Distal Chevron Osteotomy

Lee, Kyung Tai; Young, Ki Won; Kim, J Young; Cha, Seung Do; Kim, Eung Su; Ahn, Young Joo

Abstract

PURPOSE: To evaluate a symptomatic bunionette managed by a distal chevron osteotomy.
MATERIALS AND METHODS
From 1997, among eighty-three patients who had been treated for a bunionette deformity with a distal chevron osteotomy, 17 patients, who had no other associated diseases, were reviewed retrospectively. The VAS pain score and AOFAS score, the patient satisfaction level, shoe selectability and disappearance of the callus on the foot were examined. The 5th metatarso-phalangeal angle and 4th and 5th intermetatarsal angle were measured using AP plain radiography. The bunionette was classified as types 1, 2, and 3 and the treatment results were analyzed.
RESULTS
8 male and 9 female patients were enrolled in this study. The mean age of the patients was 33.6 years (21-49 years). The mean follow-up period was 37.6 months (20-62 months). The pain VAS scores were 7.9 preoperatively and 1.2 postoperatively. The last follow-up AOFAS score was 94.7, and all patients were ranked at the very satisfied or satisfied level. All patients had also good shoe selectability and the callus on the lateral sole had disappeared. The preoperative 4th and 5th intermetatarsal angle (mean 10.2 degrees) and the 5th metatarso-phalangeal angle (mean 21.4 degrees) improved to 2.7 degrees and 7.2 degrees after surgery, respectively. There was a type 1, 2 and 3 deformity in 2 (12%), 1 (6%) and 14 patients (82%), respectively. The results among the types were satisfactory.
CONCLUSION
A distal chevron osteotomy for the treatment of a symptomatic bunionette is safe, easy and can reduce the signs and symptoms. Regardless of the types of deformity, a distal chevron osteotomy can obtain satisfactory results.