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 se ries where the clinical and radiographic results of the original chevr on 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 followup of 3 years. Clinically there was no difference in the sa tisfaction rate of the two groups, with 58 satisfied and partially sat isfied in the 62 operated by chevron osteotomy alone, and 42 of 44 in the group where adductor tenotomy was added. The hallux valgus angle d ecreased by 7.5 degrees in the group operated with chevron osteotomy a nd by 9.8 degrees (P 0.04) when an adductor tenotomy was added. The ma jor objective factor affecting satisfaction was the attainment of a de creased ball circumference, shown by the fact that dissatisfied patien ts had a greater postoperative ball circumference than both satisfied and partially satisfied patients, whereas there were no radiographic c orrelations to satisfaction. We cannot recommend adding adductor tenot omy to the chevron osteotomy.