COMBINATION CHEVRON PLUS AKIN OSTEOTOMY FOR HALLUX-VALGUS - SHOULD AGE BE A LIMITING FACTOR

Current literature consistently precludes the chevron osteotomy for bu nion correction in patients older than age 50 years. We retrospectivel y reviewed 47 patients (73 bunions) with an average age of 62 years (r ange, 55-81 years old) who had a chevron-Akin double osteotomy. The me an follow-up was 4 years, 6 months (range, 2 years, 3 months to 8 year s, 2 months). The overall satisfaction rate was 95%. No significant pa in or stiffness in the first metatarsophalangeal joint occurred in com parison with other bunion procedures. Radiographic results were better for patients with a preoperative intermetatarsal angle of less than 1 5 degrees and tibial sesamoid position of less than or equal to 2. We disagree with the current recommendation that age older than 50 years is a contraindication to a chevron procedure. The Akin osteotomy adds additional intraoperative correction of the hallux angulation and rota tion; thus, the chevron-Akin double osteotomy is a useful combination procedure. We recommend this procedure for the mild to moderate bunion deformity even in elderly patients.