Results of combined chevron osteotomy and first proximal phalangeal close-up osteotomy without soft tissue procedure with severe hallux valgus in patients aged over 60 years of age

Abstract

Introduction: Hallux valgus is associated with a medial deviation of the first metatarsal and subluxation or dislocation of the first metatarsophalangeal joint. This deformity is one of the most common chronic foot complaints, with a prevalence of up to 35.7% in elderly patients. In the present study, we examined 23 feet of 15 patients with severe hallux valgus deformity between April 2008 and December 2013. Materials and Method: The inclusion criteria were age and severe hallux valgus angle and intermetatarsal angle. Patients who had any other foot deformities, were younger than 60 years, were subjected to inadequate follow-up, had moderate and mild hallux valgus angle and intermetatarsal angle, or underwent any type of prior surgery were excluded from the study. Results: The mean preoperative hallux valgus angle and intermetatarsal angle were 46.86°(range 45°–51°) and 17.6° (range 13°–21°), respectively. The postoperative corrections achieved by chevron osteotomy and first proximal phalangeal osteotomy for hallux valgus angle and intermetatarsal angle were 21.6° (range 19°–24°) and 12.6° (range 11°–14°), respectively (p < 0.05).The mean American Orthopaedic Foot and Ankle Society hallux score improved from 35.8 (range 31–38) to 89.8 (range 87–94) (p<0.05). Conclusion: Although most studies recommend chevron osteotomy only for patients younger than 50 years of age, we did not impose an age limit in our study. © 2015, Geriatrics Society. All rights reserved.