A Clinical Study of Chevron Osteotomy in Bunion - Hallux Valgus

Kang, Chang Soo; Choi, Hun Wook

Abstract

Hallux valgus is a complex deformity consisting of more than a 20° valgus angle of the first metatarsophalangeal joint. And more than 9° between the first and second metatarsals as well as bursal hypertrophy over the medial eminance of the first metatarsal head(bunion). Many surgical procedures have been available for treating the hallux valgus complex. Johnson and Coreless have acquired sufficiently good results in modifying the Mitchell osteotomy into the chevron osteotomy. They recommend the chevron osteotomy for the hallux valgus complex with the following patient profile : younger than 50 years old, hallux valgus angle less than 40°, the first-second intermetatarsal angle less than 20°. This procedure consists of 1) medial eminance removal, 2) V-shaped intracapsular osteotomy through the first metatarsal head, 3) lateral displacement of the capsular fragment, 4) removal of the resulting projection of the first metatarsal, and 5) medial capsulorrhaphy. Our results of eleven cases of the hallux valgus deformity which were treated by the chevron osteotomy during the period form July 1985 to Februsary 1988, in the Orthopedic Department of Keimyung University Dongsan Medical Center were as follows. 1. The average age at surgery was 43 years. 2. The average valgus angle was 38° and the first-second intermetatarsal angle was 15° preoperatively. They were correted to 19° and 10° respectively. 3. All cases had complained of severe metatarsalgia preoperatively. 4. The metatarsalgia subsided in all cases, and no avascular necrosis or nonunion was found.