Distal Chevron Osteotomy With Distal Soft Tissue Procedure In Transarticular Approach For Mederate To Severe Hallux Valgus

Background:The hallux valgus is commonly seen in the clinic.Aesthetic demand of operation has been increasing with the development of economics.The distal Chevron osteotomy with distal soft tissue procedure in transarticular approach could correct the hallux valgus in 1 incision.Objective:To analyze the outcomes of distal Chevron osteotomy with distal soft tissue procedure in transarticular approach for correction of moderate to severe hallux valgus.To provide reference for clinical treatment.Methods:We reviewed 19 patients(25 feet)with moderate and severe hallux valgus that underwent distal Chevron osteotomy combined with distal soft tissue procedure in transarticular approach from January 1,2015 to December 31,2017 in Orthopaedic department of Yanbian University Hospital.All of the patients have been fixated by plate and screws.Measure the HVA,IMA and DMAA by the ateroposterior and lateral weightbearing radiographs of the feet preoperatively and posoperatively.Clinical status was evaluated by the Hallux Metatarsophalangeal Interphalangeal Scale developed by American Orthopaedic Foot and Ankle Society(AOFAS score)and VAS score.The subjective sensory of patients was evaluated postoperatively.The data were analysed by SPSS 16.0 software.Statistical significance was set at a confidence level of P<0.05.Result:At a mean followup of 16.4(10-36)months,all of the patients achieved bony union posoperatively in 10(8-13)weeks.There was no case of loosening,breakage of interner fixator,infection or recurrence of hallux valgus.Average hallux valgus angle changed from 35.2±0.2 degrees preoperatively to 10.8±0.4 degrees at final followup.Average internetatarsal angle changed from 13.4±0.4 degrees to 7.9±0.2 degrees.Average distal metatarsal articular angle changed from 15.8±0.4 degrees preoperatively to 7.9±0.2°.Average AOFAS score improved from 60.4±0.4 points to 85.5±0.5 at final followup.92 percent of patients were very satisfied or satisfied about appearance of feet.And 84 percent of patients were very satisfied or satisfied about range of motion.The data of postoperation compared with preoperative group were significantly different(P<0.05).Conclusion:The distal Chevron osteotomy with distal soft tissue procedure in transarticular approach could provide an effective means of correcting moderate to severe hallux valgus deformity.It has high levels of patient satisfication and low incidence of complications.