Distal Chevron Osteotomy Combined With Soft Tissue Release Procedure For Moderate To Severe Hallux Valgus Deformity

Objective:Distal chevron osteotomy has been widely employed to treat mild to moderate hallux valgus deformity.The purpose of the present study was to evaluate the outcomes of distal chevron osteotomy with a distal soft tissue procedure for the correction of moderate to severe hallux valgus.To provide reference for clinical diagnosis and treatment.Methods:We selected 26 patients(39 feet) that underwent distal chevron osteotomy with a distal soft tissue procedure for diagnostic moderate to severe hallux valgus deformity,From January 1, 2014 to January 1, 2016. Anteroposterior and lateral weightbearing radiographs of the foot were made preoperatively and at final followup.To measure the HVA、the IMA、the DMAA、the IPA、the MPD、the amount of joint subluxation and the TSP.Clinical status was evaluated using the Hallux Metatarsophalangeal– Interphalangeal Scale developed by the American Orthopaedic Foot and Ankle Society(AOFAS score) and VAS score.We also take the subjective sensory evaluation of patients after operation.And the correlation coefficient calculated using a statistical package commercially available(SPSS20.0). Statistical significance was set at a confidence level of p < 0.05Result:Mean AOFAS hallux metatarsophalangeal“interphalangeal score improved from 29.8 points preoperatively to 80.6 points. Mean VAS score change from 6.4 points preoperatively to 0.8 points. In the subjective sensory evaluation,94.9% of the patients were “very satisfied” or “satisfied” with their shoewear,94.9% of the patients were “very satisfied” or “satisfied” with their shoewear appearance,87.2% of the patients were “very satisfied” or “satisfied” with their range of motion.Mean HVA improved from 39.9 degrees preoperatively to 11.9 degrees postoperatively; A mean correction of 28.1 degrees. IMA changed from 17.8 degrees preoperatively to 7.1 degrees postoperatively, mean correction of firstsecond IMA was 10.7 degrees. DMAA changed from 18.6 degrees preoperatively to 4.6 degrees postoperatively, mean correction of DMAA was 14 degrees.A mean correction of 28.1 degrees. MPD changed from 0.59 mm preoperatively to-0.54 mm postoperatively, mean correction of MPD was 1.13 mm.TSP changed from 4.8 preoperatively to 2.8 postoperatively, mean correction of TSP was 2.0. There were no cases of avascular necrosis. Only 5.1%(2feets)still has the first metatarsophalangeal joint subluxation postoperativelyConclusion:Our results indicate that distal chevron osteotomy with a distal soft tissue procedure provides an effective and reliable means of correcting moderate to severe hallux valgus deformity, and that it does so with high levels of patient satisfaction and low incidence of complications.