Comparison of radiological outcomes for moderate and severe hallux valgus following distal chevron osteotomy and modified McBride procedure

Abstract

Abstract Background. Hallux valgus (HV) is a common forefoot disorder with hundreds of proposed management techniques. Distal chevron osteotomy with a modified McBride procedure has been traditionally recommended for mild-to-moderate HV because of its simple and less invasive nature with fewer complications, faster postoperative recovery, and reliable outcomes. In recent years, the indications for this procedure have expanded to include HV with severe deformities. This study aimed to directly compare the efficacy of this procedure for HV patients with moderate deformity with that in patients with the severe form of this disorder. Materials and Methods. A retrospective review of medical records identified 99 feet from 94 patients that were treated with distal chevron osteotomy with a modified McBride procedure. These feet were divided by the preoperative HV angle (HVA) and intermetatarsal angle (IMA) into the moderate (M, 64 feet) and severe groups (S, 35 feet). Baseline demographic data, preoperative and postoperative radiographic parameters were analyzed. Results. No significant differences in age, sex, body mass index, operation time, and duration of follow-up were observed between the two groups. Postoperative radiographic parameters significantly improved in both groups after treatment. Mean HVA and IMA normalized to <15° and <9°, respectively, in both groups, indicating adequate deformity correction. Improvement in the sesamoid position was better in group M compared to that in group S. The recurrence rate in group S was higher than that in group M, without statisticalsignificance (p=0.24). Conclusion. Radiological outcomes suggested that distal chevron osteotomy with a modified McBride procedure was effective and reliable in managing severe HV deformity, despite the slightly higher recurrence rate in this form of HV. Complete reduction of the sesamoids should be further emphasized during the management of severe HV deformity.