Distal chevron osteotomy with lateral release for moderate to severe hallux valgus patients aged sixty years and over
- PDF / 975,334 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 78 Downloads / 214 Views
ORIGINAL PAPER
Distal chevron osteotomy with lateral release for moderate to severe hallux valgus patients aged sixty years and over Jae Hyeon Seo 1 & Ho Seong Lee 1 & Young Rak Choi 1 & Seung Hwan Park 1 Received: 19 January 2020 / Accepted: 1 April 2020 # SICOT aisbl 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. Keywords Moderate to severe hallux valgus . Elderly . Distal chevron metatarsal osteotomy . Porotic bone . Osteoarthritis
Introduction Previously, distal chevron metatarsal osteotomy (DCMO) was considered contraindicated for patients aged more than 50 years in hallux valgus correction [1, 2]. In addition, until 1990s, several experts emphasized that DCMO is likely to fail in elderly patients [3]. However, DCMO became one of the most popular procedures ever performed even for moderate to severe deformities when combined with soft tissue procedures and Akin proximal phalangeal osteotomy [4–6]. Despite prior concerns about poor outcome of DCMO in elderly, Level of evidence: level 4 * Ho Seong Lee [email protected] 1
Department of Orthopaedic Surgery, Asan Medical Center, Seoul, South Korea
satisfactory outcomes and infrequent avascular necrosis (AVN) occurrence were later reported [7, 8]. However, according to our literature review, there was a lack of technical points on DCMO performed in elderly. Moreover, no study focused on outcome of DCMO in eld
Data Loading...
