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Clinical outcome after Chevron–Akin double osteotomy versus isolated Chevron procedure: a prospective matched group analysis

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Hallux valgus is a frequent condition of the forefoot, resulting in cosmetic deformity and pain. Chevron osteotomy (CO) is widely employed for the treatment of hallux valgus. Chevron–Akin double osteotomy (CAO) was previously described and superiority over an isolated Chevron procedure was assumed. The objective of this study was to compare the short-to-middle term outcomes of CO and CAO.

Patients and methods

This study included 72 patients with established diagnosis of mild-to-moderate hallux valgus, treated by either isolated CO or CAO. The CO group included 46 patients (mean 51.5 years) with a mean hallux valgus angle of 27°, while the CAO group included 26 subjects (mean 53.1 years) and a mean hallux valgus angle of 32° preoperatively. All patients were reviewed by physical examination, and standardized questionnaire, and pre- and postoperative standing X-rays were performed. Matched group analysis was carried out to analyze statistical differences of both techniques.

Results

The patients were assessed and group matched at a mean of 1.37 years for the CO group and 1.04 years for the CAO group, postoperatively. Mean improvement of HVA (hallux valgus angle) was 10.6° in the CO group and the CAO group improved by 17.5°. DMAA (distal metatarsal articular angle) improved in the CO group by 5.4° and in the CAO by 13.7°. Mean AOFAS score improved by 27.9 (CO) and 21.5 (CAO). Patient satisfaction was high in both groups, with a tendency towards higher values within the CAO group.

Conclusions

These findings indicate that Chevron–Akin double osteotomy is a save and practicable procedure for the treatment of mild-to-moderate hallux valgus. Superiority of combined Chevron–Akin procedure over an isolated Chevron osteotomy might be limited to distinct clinical settings, but should not be generally assumed.

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Acknowledgments

PL was supported by the Regensburger Forschungsförderung in der Medizin (ReForM).

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Authors and Affiliations

  1. Klinik und Poliklinik für Orthopädie und Orthopädische Chirurgie, für die Universität Regensburg, Asklepios Klinikum Bad Abbach, Kaiser Karl V Allee 3, 93077, Bad Abbach, Germany

    Philipp Lechler, Christine Feldmann, Franz Xaver Köck, Jens Schaumburger & Joachim Grifka

  2. Department of Orthopedic and Trauma Surgery, Kreisklinikum Calw-Nagold, Calw, Germany

    Martin Handel

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  1. Philipp Lechler
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  2. Christine Feldmann
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  3. Franz Xaver Köck
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  4. Jens Schaumburger
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  5. Joachim Grifka
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  6. Martin Handel
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Correspondence to Philipp Lechler.

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Lechler, P., Feldmann, C., Köck, F.X. et al. Clinical outcome after Chevron–Akin double osteotomy versus isolated Chevron procedure: a prospective matched group analysis. Arch Orthop Trauma Surg 132, 9–13 (2012). https://doi.org/10.1007/s00402-011-1385-3

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  • DOI: https://doi.org/10.1007/s00402-011-1385-3

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