Rotational biplanar Chevron osteotomy

Abstract

Introduction: The Chevron osteotomy is a reliable and popular osteotomy for treating hallux valgus worldwide. Many modifications have been described, but none of them address the rotational deformity of the first metatarsal. The objective of this study is to describe a variation of biplanar Chevron osteotomy which can address first metatarsal rotation when necessary.

Methods: The indications for the Rotational Biplanar Chevron Osteotomy (RBCO) are mild to moderate hallux valgus deformity associated with hallux pronation related to internal rotation of the first metatarsal bone. We describe a technique that uses a medial based wedge parallel to the plantar limb of the osteotomy in order to make the distal fragment free to correct rotation.

Results: The more recent concern about hallux valgus surgery is the very interesting concept that this deformity really occurs in three different planes, and we may have mistreated the rotation component with our current techniques. Many authors have revisited many common techniques in order to adapt them to correct metatarsal pronation. To our best knowledge, this is the first paper to describe a modification of the Chevron osteotomy to address the rotation of the first metatarsal.

Conclusion: We can conclude that the rotational biplanar Chevron osteotomy can be an useful tool in the treatment of mild hallux valgus associated with metatarsal pronation.

Keywords: Chevron osteotomy; Hallux valgus; Pronation; Rotational deformity.