Fixation methods of Chevron osteotomy in percutaneous surgery for hallux valgus: a comparative study

Abstract

Objectives: Evaluate the results of percutaneous surgery for hallux valgus, comparing three fixation methods of Chevron osteotomy of the first metatarsal. Methods: Seventy-one feet were submitted to percutaneous surgery with Chevron osteotomy between 2017 and 2022; 41 feet were fixed with screws, 18 with two Kirschner wires, and 12 with one screw and one Kirschner wire. Clinical results were evaluated using the American Orthopaedic Foot & Ankle Society (AOFAS) Hallux Metatarsophalangeal-Interphalangeal Score (MTP-IP). Radiographic outcomes included hallux valgus angle (HAV), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), and sesamoid displacement (SD). Patients had a mean follow-up of 25 months. Results: No statistically significant difference was found among the three groups in the AOFAS score (p < 0.001). The means of HVA, IMA, DMAA, and SD decreased from preoperative to postoperative in all techniques similarly. Among the total sample, 17 presented some complications. There was no statistically significant difference in complications among the techniques. Conclusion: Clinical and radiological results of the three fixation methods for percutaneous Chevron osteotomies were equivalent, with no disadvantage regarding radiographic parameters or increased operative complications. Level of Evidence IV; Therapeutic Studies; Case Series.