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International Orthopaedics

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01-06-2020 | Osteoarthrosis | Original Paper

Distal chevron osteotomy with lateral release for moderate to severe hallux valgus patients aged sixty years and over

Authors: Jae Hyeon Seo, Ho Seong Lee, Young Rak Choi, Seung Hwan Park

Published in: International Orthopaedics | Issue 6/2020

Abstract

Purpose

To analyze the outcome of distal chevron metatarsal osteotomy (DCMO) with lateral release for moderate to severe hallux valgus patients aged 60 years or more.

Methods

Consecutive 77 DCMOs in 54 patients were evaluated. Average age at operation was 65.1 ± 4.3 (range 60~79) years; the mean follow-up period was 20.5 ± 14.2 (range 12~93) months. Hallux valgus angle (HVA), first to second inter-metatarsal angle (IMA), and lateral sesamoid grades were measured. Considering the weak bone quality of the patients, fixation failures such as pin migration, callus formation, delayed union, and first metatarsal bone shortening were reviewed. Osteoarthritis (OA) of the first metatarsophalangeal joint (MTPJ), limitation of 1st MTPJ motion (LOM), and transfer metatarsalgia were also reviewed.

Results

HVA, IMA, and sesamoid grades were improved at three months and final follow-up. The mean HVA was 36.9° ± 7.0° preoperatively and 6.8° ± 7.1° at final follow-up. The mean correction angle of HVA was 31.3° ± 8.5° at three months and 30.1° ± 8.9° at final follow-up. The mean IMA was 16.3° ± 3.0° pre-operatively and 7.7° ± 2.7° at final follow-up. Hallux varus deformity was observed in three feet. Instability of osteotomy site was observed in one foot. Mean metatarsal shortening length was 1.26 ± 2.1 mm at three month follow-up. There were no cases of transfer metatarsalgia after operation. OA was observed in four feet post-operatively. LOM was observed in ten feet (13.0%). There were no instances of re-fracture or avascular necrosis (AVN).

Conclusion

Despite concerns about aggravation of OA and fixation failure, distal chevron osteotomy with lateral release was safe on patients aged 60 years and over.

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Title: Distal chevron osteotomy with lateral release for moderate to severe hallux valgus patients aged sixty years and over
Authors: Jae Hyeon Seo
Ho Seong Lee
Young Rak Choi
Seung Hwan Park
Publication date: 01-06-2020
Publisher: Springer Berlin Heidelberg
Keywords: Osteoarthrosis
Hallux Valgus
Hallux Varus
Osteoarthrosis
Hallux Varus
Hallux Valgus
Published in: International Orthopaedics / Issue 6/2020
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-020-04562-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Distal chevron osteotomy with lateral release for moderate to severe hallux valgus patients aged sixty years and over

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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