Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.
Foot Ankle Int. 2010 Aug;31(8):683-8. doi: 10.3113/FAI.2010.0683.
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.
We reviewed 76 patients (86 feet) that underwent distal chevron osteotomy with a distal soft tissue procedure for symptomatic moderate to severe hallux valgus deformity. At a mean followup of 31 months, all patients were evaluated using subjective, objective and radiographic measurements.
Ninety-four percent of the patients were very satisfied or satisfied. Average AOFAS score improved from 54.7 points preoperatively to 92.9 at final followup. Average hallux valgus angle changed from 36.2 degrees preoperatively to 12.4 degrees at final followup, and average first-second intermetatarsal angle changed from 17.1 to 7.3 degrees. Average tibial sesamoid position changed from 2.4 preoperatively to 1.2 at final followup. Dorsal angulation of the head was observed in two feet, and plantaflexion of the head in four feet. There were no cases of avascular necrosis of the metatarsal head.
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.
远端跖骨 V 形截骨术已广泛应用于治疗轻度至中度拇外翻畸形。本研究的目的是评估远端跖骨 V 形截骨术联合远端软组织手术治疗中重度拇外翻的疗效。
我们回顾性分析了 76 例（86 足）因中重度拇外翻畸形而接受远端跖骨 V 形截骨术联合远端软组织手术的患者。平均随访 31 个月后，采用主观、客观和影像学测量对所有患者进行评估。
94%的患者非常满意或满意。AOFAS 评分平均从术前的 54.7 分提高到末次随访时的 92.9 分。平均拇外翻角从术前的 36.2°变为末次随访时的 12.4°，平均第一二跖骨间角从 17.1°变为 7.3°。平均跖骨头胫骨籽骨位置从术前的 2.4 变为末次随访时的 1.2。2 足出现跖骨头背屈，4 足出现跖屈。无跖骨头缺血性坏死病例。
我们的结果表明，远端跖骨 V 形截骨术联合远端软组织手术是治疗中重度拇外翻畸形的一种有效且可靠的方法，具有较高的患者满意度和较低的并发症发生率。
