The Chevron osteotomy for correction of hallux valgus - Comparison of findings after two and five years of follow-up

Background: The chevron osteotomy, an accepted method for the correction of mild and moderate hallux valgus, is generally advocated for patients young er than the age of fifty years. The purposes of this prospective study were to compare the short-term (two-year) and intermediate-term (five-year) res ults of this operation with respect to patient satisfaction, flexion and ex tension of the metatarsophalangeal joint, maintenance of correction, and de velopment of arthrosis and to determine whether the effectiveness of the pr ocedure was limited by age. Methods: Between April 1991 and September 1992, the chevron osteotomy was p erformed for the treatment of mild-to-moderate hallux valgus deformity in s ixty-six consecutive feet. Forty-three patients (fifty-seven feet) were ava ilable for follow-up at both two and five years postoperatively. The two-ye ar and five-year clinical assessments were based on the American Orthopaedi c Foot and Ankle Society's hallux-metatarsophalangeal-interphalangeal scale . Results: Between the two-year and five-year follow-up evaluations, there wa s only a minimal change in over-all patient satisfaction, and the average s core on the hallux-metatarsophalangeal-interphalangeal scale was unchanged. The passive range of motion of the first metatarsophalangeal joint decreas ed between the preoperative assessment and the two-year follow-up evaluatio n and was unchanged at the five-year follow-up evaluation. Radiographic eva luation showed no changes in the hallux valgus or intermetatarsal angle bet ween the two-year and five-year evaluations, although the number of feet wi th arthrosis of the metatarsophalangeal joint increased slightly, from eigh t to eleven. Patients aged fifty years or older did as well as younger pati ents. Conclusions At these two follow-up periods, the chevron osteotomy was found to be a reliable procedure for the correction of mild and moderate hallux valgus deformity, and outcome did not differ on the basis of age.