Stabilization of chevron osteotomy with a capsuloperiosteal flap: Results in 15 years of follow-up

• Published in: Journal of orthopaedic surgery (Hong Kong) Vol. 27; no. 1; p. 2309499019833059
• Main Authors: Koken, Murat, Basat, H Cagdas, Kara, A Hakan, Us, A Kemal, Guclu, Berk
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2019; Sage Publications Ltd; SAGE Publishing
• Subjects: Adult; Female; Follow-Up Studies; Hallux Valgus - diagnostic imaging; Hallux Valgus - surgery; Humans; Male; Middle Aged; Osteotomy - methods; Radiography; Range of Motion, Articular; Retrospective Studies; Surgical Flaps; Time Factors; Treatment Outcome; Young Adult; hallux valgus; osteotomy; chevron; modification
• ISSN: 2309-4990; 1022-5536; 2309-4990
• DOI: 10.1177/2309499019833059

Purpose: Distal chevron osteotomy (DCO) is used more frequently than other methods for the correction of mild-to-moderate hallux valgus deformity because it is markedly more stable. Here, we evaluated the use of a capsuloperiosteal flap to stabilize DCO and presented our last longer follow-up. Methods: This study included a total of 57 patients (86 feet) made up of 50 women (79 feet) and 7 men (7 feet) with a mean age of 37.8 years who were diagnosed with hallux valgus and met the inclusion criteria. These patients received treatment using a capsuloperiosteal flap to stabilize DCO from 1994 to 2000. Clinical outcomes of the patients were assessed using the American Orthopaedic Foot and Ankle Society hallux scale. Results: The mean follow-up duration was 14.8 years. The score increased from a preoperative mean of 52 points to a mean of 90.5 points at last follow-up. The mean hallux valgus angle changed from 30.3° preoperatively to 14.4° postoperatively at the last follow-up. The first to second intermetatarsal angle changed from 13.6° preoperatively to 10.5° postoperatively. The correction in the range of motion proved to be consistent with only an average of 1° correction loss and 5.5° loss. Eighty-four feet (97.6%) were pain-free. Discomfort with shoe wear was absent in 82 feet (95.3%) postoperatively, and 23 of 24 (95.8%) patients were fascinated cosmetically. Conclusion: Correction of mild-to-moderate hallux valgus deformity with the use of capsuloperiosteal flap for stabilization of DCO provided findings comparable with the literature regarding clinical and radiological outcomes at long-term follow-up. Level of Evidence: IV, Retrospective Case Series.