Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr 6;13(4):e14334.
doi: 10.7759/cureus.14334.

A New Alternative Surgical Treatment of Hallux Valgus, in Moderate to Severe Cases of the Disease With a Two-and-a-Half-Year Follow-Up

Prodromos Natsaridis  1 , Vaios Goulas  1 , Themistoklis Poulios  2 , Vasileios Akrivos  1 , Christos Alexandropoulos  1 , Stefanos Tsourvakas  1 , Aristeidis H Zibis  3
Affiliations

A New Alternative Surgical Treatment of Hallux Valgus, in Moderate to Severe Cases of the Disease With a Two-and-a-Half-Year Follow-Up

Prodromos Natsaridis et al. Cureus. .

Abstract

The study aims to evaluate the treatment of moderate to severe forms of hallux valgus with the lowest invasiveness in soft tissues and especially with an alternative modified Chevron osteotomy of the first metatarsal. Additionally, it emphasizes the necessity of the modified McBride procedure (capsuloplasty and release of specific concrete soft tissue structures) and the importance of the soft tissue manipulation in the particular surgery intra-operatively, as well as postoperative medical and personal care and duration of rehabilitation. Patients with an average age 58 years (range 51-65), who underwent a Chevron type osteotomy with combination of soft tissues interventions laterally and medially of the first metatarsophalangeal joint, for symptoms they had of systematic hallux valgus without any other degenerative problems in metatarsophalangeal joint between 2017 to the beginning of 2018, were retrospectively reviewed with an average follow-up of 29 months (range 26-31).

Keywords: cannulated screw; chevron; halux valgus; mcbride; modified; osteotomy.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. The deformity of the hallux valgus.
Figure 2
Figure 2. Medial longitudinal 3-4 cm skin incision.
Figure 3
Figure 3. Longitudinal capsulotomy.
Figure 4
Figure 4. Overview of deformation and initial steps of surgical repair before “bunionectomy”.
Figure 5
Figure 5. Overview after “bunionectomy”.
Figure 6
Figure 6. Marking the center of the first metatarsal head with a k-wire.
Figure 7
Figure 7. First-dorsal osteotomy.
Figure 8
Figure 8. Second-plantar osteotomy
Figure 9
Figure 9. Translating the osteotomized head laterally with the help of a reduction forceps.
Figure 10
Figure 10. Temporal stabilization with a k-wire.
Figure 11
Figure 11. Measurement and screw installation.
Figure 12
Figure 12. Remodeling of the osteotomy.
Figure 13
Figure 13. Lateral soft tissue release.
Figure 14
Figure 14. Excision of the excessive capsular tissue.
Figure 15
Figure 15. Capsulorrhaphy.
Figure 16
Figure 16. Subcuticular skin closure.
Figure 17
Figure 17. Results of the AOFAS Hallux MTP-IP and SF-12 PCS-MCS scores.
AOFAS: American Orthopedic Foot and Ankle Society; MTP-IP: MetaTarsoPhalangeal-InterPhalangeal; PCS: physical component score; MCS: mental component score; SF-12: Short Form-12.
Figure 18
Figure 18. Results of the VAS score.
VAS: visual analog scale.
Figure 19
Figure 19. Diagram of correction of the HVA and IMA.
HVA: hallux valgus angle; IMA: intermetatarsal angle.
Figure 20
Figure 20. Man - 47-year-old medic (GP) with moderate deformity preoperatively.
Figure 21
Figure 21. Foot X-ray, anteroposterior view, 27 months post-operatively.
Figure 22
Figure 22. Foot X-ray, lateral view, 27 months post-operatively.
Figure 23
Figure 23. Woman - 52-year-old housewife with moderate deformity preoperatively.
Figure 24
Figure 24. Clinical picture of the foot after 29 months post-operatively.
See this image and copyright information in PMC

References

    1. Foot deformities in women are associated with wearing high-heeled shoes. Puszczałowska-Lizis E, Dąbrowiecki D, Jandziś S, Żak M. Med Sci Monit. 2019;25:7746–7754. - PMC - PubMed
    1. Mechanical properties and morphologic features of intrinsic foot muscles and plantar fascia in individuals with hallux valgus. Taş S, Çetin A. https://doi.org/10.1016/j.aott.2019.03.009. Acta Orthop Traumatol Turc. 2019;53:282–286. - PMC - PubMed
    1. Chevron osteotomy in hallux valgus. Ten-year results of 112 cases. Schneider W, Aigner N, Pinggera O, Knahr K. https://doi.org/10.1302/0301-620X.86B7.15108. J Bone Joint Surg Br. 2004;86:1016–1020. - PubMed
    1. A modified Austin/chevron osteotomy for treatment of hallux valgus and hallux rigidus. Vasso M, Del Regno C, D'Amelio A, Schiavone Panni A. https://link.springer.com/article/10.1007/s10195-015-0366-7. J Orthop Traumatol. 2016;17:89–93. - PMC - PubMed
    1. Distal chevron osteotomy with distal soft tissue procedure for moderate to severe hallux valgus deformity. Bai LB, Lee KB, Seo CY, Song EK, Yoon TR. https://doi.org/10.3113/FAI.2010.0683. Foot Ankle Int. 2010;31:683–688. - PubMed

LinkOut - more resources