Chevron osteotomy for hallux valgus not improved by additional adductor tenotomy. A prospective, randomized study of 84 patients.

We investigated 106 feet in 84 patients in a prospective randomized series where the clinical and radiographic results of the original chevron osteotomy were compared to the same procedure with the addition of an adductor tenotomy in patients averaging 47 years of age and with a mean follow-up of 3 years. Clinically there was no difference in the satisfaction rate of the two groups, with 58 satisfied and partially satisfied in the 62 operated by chevron osteotomy alone, and 42 of 44 in the group where adductor tenotomy was added. The hallux valgus angle decreased by 7.5 degrees in the group operated with chevron osteotomy and by 9.8 degrees (P 0.04) when an adductor tenotomy was added. The major objective factor affecting satisfaction was the attainment of a decreased ball circumference, shown by the fact that dissatisfied patients had a greater postoperative ball circumference than both satisfied and partially satisfied patients, whereas there were no radiographic correlations to satisfaction. We cannot recommend adding adductor tenotomy to the chevron osteotomy.