Chevron osteotomy in hallux valgus treatment results of 14 cases

According to the algorithm published by Coul and Stephens, chevron osteotomy is indicated for mild to moderate hallux valgus with hallux valgus angle (HVA)<35, intermetatarsal angle (IMA) <14 and no signs of first MP joint degeneration. The goal of this paper is the retrospective evaluation of 12 patients (10 woman and 2 men) who have underwent 14 chevron osteotomies. Mean age was 58 years (range 39-71), preoperative HVA 31° SD 5,1°, IMA 10° SD 3,7°, and distal metatarsal articular angle (DMAA) 12° SD 3,7°. Mean follow up 2 years and 2 months (14-47 months). Mean AOFAS score increase after the operation 42 pts 95 % CI 28 to 55. Mean HVA decreased from 31° preoperatively to 19° postoperatively. Mean difference 12 °; 95 % CI 9,6 ° to 14,4°. Mean preoperative IMA 10°, postoperatively 6°. Mean difference 3,6°; 95% CI 1° to 6,1°. Mean sesamoids subluxation index was 1,7 preoperatively and has decreased to 1,2 postoperatively. Mean difference 0,5, 95% CI 0,06 to 0,93- but it is not statistically significant. All preoperatively incongruent joints have became congruent after the operation. Chevron has not corrected IMA in feet with high preoperative DMAA. The DMAA assessment is essential for choosing between the original chevron procedure and the modification of this operation described by Chou, Mann and Casillas which is intended for the DMAA correction.