The purpose of this brief paper is to present the preliminary results of a modified Austin/chevron
osteotomy for treatment of
hallux valgus and
hallux rigidus. In this procedure, the dorsal arm of the
osteotomy is performed orthogonal to the horizontal plane of the first metatarsal, the main advantage being that this allows much easier and more accurate multiplanar correction of first
metatarsal deformities. From 2010 to 2013, 184 consecutive patients with symptomatic
hallux valgus and 48 patients with
hallux rigidus without severe metatarsophalangeal joint degeneration underwent such modified chevron
osteotomy. Mean patient age was 54.9 (range 21-70) years, and mean follow-up duration was 41.7 (range 24-56) months. Ninety-three percent of patients were satisfied with the surgery. Mean American Orthopaedic Foot and Ankle Society (AOFAS) score improved from 56.6 preoperatively to 90.6 at last follow-up, and mean visual analog scale (VAS)
pain score decreased from 5.7 preoperatively to 1.6 at final follow-up (p < 0.05). In patients treated for
hallux valgus, mean
hallux valgus angle decreased from 34.1° preoperatively to 6.2° at final follow-up, and mean intermetatarsal angle decreased from 18.5° preoperatively to 4.1° at final follow-up (p < 0.05). One patient developed postoperative transfer
metatarsalgia, treated successfully with second-time percutaneous
osteotomy of the minor metatarsals, whilst one patient had
wound infection that resolved with systemic
antibiotics.
LEVEL OF EVIDENCE: Level IV.