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Preoperative radiological factors correlated to long-term recurrence of hallux valgus following distal chevron osteotomy.
Foot Ankle Int 2014; 35(12):1262-7FA

Abstract

BACKGROUND

The purpose of this article was to analyze the long-term radiologic results after distal chevron osteotomy for hallux valgus treatment and to determine the preoperative radiographic factors correlating with radiological recurrence of the deformity.

METHODS

The study included 100 consecutive patients who received distal chevron osteotomy for hallux valgus. The osteotomy included fixation with an absorbable pin in 50 cases, and no fixation in the other 50. For 6 weeks postoperatively, half of each group used a soft cast and half had a traditional elastic bandage. Weight-bearing radiographs were evaluated at 6 weeks, 6 months, 1 year, and a mean of 7.9 (range, 5.8-9.4) years postoperatively.

RESULTS

At the final follow-up, radiological recurrence of hallux valgus deformity (HVA > 15 degrees) was observed in 56 feet (73%). Eleven feet (14%) had mild recurrence (HVA < 20 degrees), 44 (57%) moderate (20 degrees ≥ HVA < 40 degrees), and 1 (1%) severe (HVA ≥ 40 degrees). All recurrences were painless, and thus no revision surgery was required. Long-term hallux valgus recurrence was significantly affected by preoperative congruence, DMAA, sesamoid position, HVA, and I/II IMA.

CONCLUSIONS

Radiological recurrence of hallux valgus deformity of 15 degrees or more was very common at long-term follow-up after distal chevron osteotomy. Preoperative congruence, DMAA, sesamoid position (LaPorta), HVA, and I/II IMA significantly affected recurrence.

LEVEL OF EVIDENCE

Level III, comparative case series.

Authors+Show Affiliations

Department of Surgery, Division of Orthopaedic and Trauma Surgery, Oulu University Hospital, Oulu, Finland.Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.Department of Surgery and Anesthesiology, Oulu University Hospital, Oulu, Finland.Department of Surgery, Division of Orthopaedic and Trauma Surgery, Oulu University Hospital, Oulu, Finland.Department of Surgery, Division of Orthopaedic and Trauma Surgery, Oulu University Hospital, Oulu, Finland juhana.leppilahti@ppshp.fi.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25192724

Citation

Pentikainen, Ilkka, et al. "Preoperative Radiological Factors Correlated to Long-term Recurrence of Hallux Valgus Following Distal Chevron Osteotomy." Foot & Ankle International, vol. 35, no. 12, 2014, pp. 1262-7.
Pentikainen I, Ojala R, Ohtonen P, et al. Preoperative radiological factors correlated to long-term recurrence of hallux valgus following distal chevron osteotomy. Foot Ankle Int. 2014;35(12):1262-7.
Pentikainen, I., Ojala, R., Ohtonen, P., Piippo, J., & Leppilahti, J. (2014). Preoperative radiological factors correlated to long-term recurrence of hallux valgus following distal chevron osteotomy. Foot & Ankle International, 35(12), pp. 1262-7. doi:10.1177/1071100714548703.
Pentikainen I, et al. Preoperative Radiological Factors Correlated to Long-term Recurrence of Hallux Valgus Following Distal Chevron Osteotomy. Foot Ankle Int. 2014;35(12):1262-7. PubMed PMID: 25192724.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preoperative radiological factors correlated to long-term recurrence of hallux valgus following distal chevron osteotomy. AU - Pentikainen,Ilkka, AU - Ojala,Risto, AU - Ohtonen,Pasi, AU - Piippo,Jouni, AU - Leppilahti,Juhana, Y1 - 2014/09/05/ PY - 2014/9/7/entrez PY - 2014/9/7/pubmed PY - 2015/8/1/medline KW - Hallux valgus KW - chevron osteotomy KW - congruence KW - distal metatarsal articular angle KW - sesamoid arthritis KW - tibial sesamoid SP - 1262 EP - 7 JF - Foot & ankle international JO - Foot Ankle Int VL - 35 IS - 12 N2 - BACKGROUND: The purpose of this article was to analyze the long-term radiologic results after distal chevron osteotomy for hallux valgus treatment and to determine the preoperative radiographic factors correlating with radiological recurrence of the deformity. METHODS: The study included 100 consecutive patients who received distal chevron osteotomy for hallux valgus. The osteotomy included fixation with an absorbable pin in 50 cases, and no fixation in the other 50. For 6 weeks postoperatively, half of each group used a soft cast and half had a traditional elastic bandage. Weight-bearing radiographs were evaluated at 6 weeks, 6 months, 1 year, and a mean of 7.9 (range, 5.8-9.4) years postoperatively. RESULTS: At the final follow-up, radiological recurrence of hallux valgus deformity (HVA > 15 degrees) was observed in 56 feet (73%). Eleven feet (14%) had mild recurrence (HVA < 20 degrees), 44 (57%) moderate (20 degrees ≥ HVA < 40 degrees), and 1 (1%) severe (HVA ≥ 40 degrees). All recurrences were painless, and thus no revision surgery was required. Long-term hallux valgus recurrence was significantly affected by preoperative congruence, DMAA, sesamoid position, HVA, and I/II IMA. CONCLUSIONS: Radiological recurrence of hallux valgus deformity of 15 degrees or more was very common at long-term follow-up after distal chevron osteotomy. Preoperative congruence, DMAA, sesamoid position (LaPorta), HVA, and I/II IMA significantly affected recurrence. LEVEL OF EVIDENCE: Level III, comparative case series. SN - 1944-7876 UR - https://www.unboundmedicine.com/medline/citation/25192724/Preoperative_radiological_factors_correlated_to_long_term_recurrence_of_hallux_valgus_following_distal_chevron_osteotomy_ L2 - http://journals.sagepub.com/doi/full/10.1177/1071100714548703?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -