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Halluks Valgus tedavisinde modifiye chevron osteotomisi uygulamalarımızın orta ve uzun dönem sonuçları

Year 2019, Volume 26, Issue 3, 306 - 311, 01.09.2019
https://doi.org/10.17343/sdutfd.465888

Abstract

Giriş:  Halluks valgus nedeniyle modifiye Chevron osteotomisi uyguladığımız olgularımızın orta ve uzun dönem sonuçlarını değerlendirdik.

 

Hastalar ve Yöntem: Takip süreleri 24 aydan uzun-60 aydan kısa olan 37 olgu (%57.8) orta dönem takip olguları (Grup 1) ve takip süresi 60 aydan uzun olanlar 27 olgu (%42.2) (Grup 2) uzun dönem takip olguları olarak belirlendi. Tüm olguların yaş, cinsiyet, taraf ve takip süreleri kaydedildi. Cerrahi öncesi ve son kontrollerinde halluks valgus açısı ve intermetatarsal açıları ölçüldü. Klinik sonuçlar  Amerikan Ortopedik Ayak-Ayak Bileği Derneği Skorları (AOFAS) ile değerlendirildi.

 

Bulgular: Çalışma 21’i (%32.8) erkek, 43’ü (%67.2) erkek toplam 64 olgu ile yapılmıştır. Yaş ortalaması 47.41±9.80 (21-74) yıldır. Ortalama takip süreleri 53.25±19.18 (24-93) aydır. Olguların 34’ünün (%53.1) sağ, 30’unun (%46.9) sol tarafına cerrahi uygulanmıştır. HVA ortalaması Grup 1’de operasyon öncesi 33,11±3,39 iken operasyon sonrası 14,59±1,88 ; Grup 2’de ise operasyon öncesi 33,85±3,58 iken operasyon sonrası 14,11±1,91 bulunmuştur.  IMA ortalaması Grup 1’de operasyon öncesi 11,43±1,3 iken operasyon sonrası 7,76±1,5; Grup 2’de ise operasyon öncesi 11,7±1,3  iken operasyon sonrası  7,74±1,56 bulunmuştur.  Grupların AOFAS değerlendirmeleri için Grup 1 de operasyon öncesi ortalama 50,03±8,09 iken operasyon sonrası 90,35±6,75 bulundu. Buna karşılık Grup 2 de operasyon öncesi 49,78±8,96 iken operasyon sonrası 90,26±6,59 olarak bulundu.

 

Sonuç: Modifiye Chevron osteotomisi uygulanan olguların klinik sonuçlarının hasta memnuniyeti açısından, hem orta hem de uzun dönemde iyi olduğu, hallux valgus deformitesinin cerrahi tedavisinde uygun olgularda tercih edilebilecek iyi bir cerrahi metod olarak görülmektedir. 

References

  • 1. Perera AM, Mason L, Stephens MM. The pathogenesis of hallux valgus. J Bone Joint Surg Am. 2011 Sep 7;93(17):1650-1661.
  • 2. Coughlin MJ, Jones CP. Hallux valgus: demographics, etiology, and radiographic assessment. Foot Ankle Int. 2007 Jul;28(7):759-777.
  • 3.Coughlin MJ. Hallux Valgus. J Bone Joint Surg Am.1996; 78(6): 932-966.
  • 4. Robinson AH, Limbers JP. Modern concepts in the treatment of hallux valgus. J Bone Joint Surg Br. 2005 Aug; 87(8): 1038-1045.
  • 5. Schneider W, Aigner N, Pinggera O, Knahr K. Chevron osteotomy in hallux valgus. Ten-year results of 112 cases. J Bone Joint Surg Br. 2004 Sep;86(7):1016-20.
  • 6.Austin DW, Leventen EO. A new osteotomy for hallux valgus: a horizontally directed "V" displacement osteotomy of the metatarsal head for hallux valgus and primus varus. Clin Orthop Relat Res. 1981 Jun;(157):25-30.
  • 7. Toepfer A, Harrasser N, Lenze F, Pohlig F, von Eisenhart-Rothe R. Current concepts in diagnostics and treatment of hallux valgus deformity. MMW Fortschr Med. 2015 Jun 11;157(11):37-40.
  • 8. Hart ES, deAsla RJ, Grottkau BE. Current concepts in the treatment of hallux valgus.Orthop Nurs. 2008 Sep-Oct;27(5):274-80; quiz 281-2.
  • 9.Tai CC, Ridgeway S, Ramachandran M, Ng VA, Devic N, Singh D. Patient expectations for hallux valgus surgery. J Orthop Surg (Hong Kong). 2008 Apr;16(1):91-5.
  • 10. Lindgren U, Turan I: A new operation for hallux valgus. Clin Orthop Relat Res. 1983 May; (175):179–183.
  • 11.Velkes S, Ganel A, Nagris B, Lokiec F. Chevron osteotomy in the treatment of hallux valgus.J Foot Surg. 1991 May-Jun;30(3):276-8.
  • 12.Horne G, Tanzer T, Ford M. Chevron osteotomy for the treatment of hallux valgus.Clin Orthop Relat Res. 1984 Mar;(183):32-6.
  • 13.Johnson KA, Cofield RH, Morrey BF. Chevron osteotomy for Hallux Valgus. Clin Orthop Relat Res.1979 Jul-Aug; (142):44-47.
  • 14. Zimmer TJ, Johnson KA, Klassen RA. Treatment of hallux valgus in adolescents by the chevron osteotomy. Foot Ankle. 1989 Feb;9(4):190-3.
  • 15.Okuda R, Kinoshita M, Morikawa J, Yasuda T, Abe M. Proximal metatarsal osteotomy: relation between 1- to greater than 3-years results.Clin Orthop Relat Res. 2005 Jun;(435):191-6.
  • 16.Veri JP, Pirani SP, Claridge R. Crescentic proximal metatarsal osteotomy for moderate to severe hallux valgus: a mean 12.2 year follow-up study. Foot Ankle Int. 2001 Oct;22(10):817-22.
  • 17.Sammarco GJ, Idusuyi OB. Complications after surgery of the hallux. Clin Orthop Relat Res. 2001 Oct;(391):59-71.
  • 18. Lewis RJ, Feffer HL. Modified chevron osteotomy of the first metatarsal. Clin Orthop Relat Res. 1981 Jun;(157):105-9.
  • 19.Horne G, Tanzer T, Ford M. Chevron osteotomy for the treatment of hallux valgus. Clin Orthop Relat Res. 1984 Mar;(183):32-6.
  • 20.Lillich JS, Baxter DE. Bunionectomies and related surgery in the elite female middle-distance and marathon runner. Am J Sports Med. 1986 Nov-Dec;14(6):491-3.
  • 21. Grill F, Hetherington V, Steinböck G, Altenhuber J. Experiences with the chevron (V-)osteotomy on adolescent hallux valgus. Arch Orthop Traum Surg.1986;106(1):47-51.
  • 22.Klosok JK, Pring DJ, Jessop JH, Maffulli N. Chevron or Wilson metatarsal osteotomy for hallux valgus. A prospective randomised trial. J Bone Joint Surg Br. 1993 Sep;75(5):825-9.
  • 23.Kinnard P, Gordon D. A Comparison between Chevron and Mitchell Osteotomies for Hallux Valgus. Foot Ankle. 1984 Mar-Apr;4(5):241-3.
  • 24. Meier PJ, Kenzora JE. The risks and benefits of distal first metatarsal osteotomies. Foot Ankle. 1985 Aug;6(1):7-17.

Mid and long term results of modified chevron osteotomy in hallux valgus

Year 2019, Volume 26, Issue 3, 306 - 311, 01.09.2019
https://doi.org/10.17343/sdutfd.465888

Abstract

Introduction : We evaluated mid and long term results of modified Chevron osteotomy in hallux valgus patients.

Materials and Method: Patients are assigned two groups; Group 1 who have a follow-up period between 24-60 months (37 patients:%57,8) and Group 2 longer than 60 months (27 patients:%42,2). All patients’ age, sex, operation side and follow-up periods were recorded. Hallux valgus angle (HVA) and intermetatarsal angle (IMA) were evaluated pre and postoperatively. Clinical results were evaluated with American Orthopaedic Foot and Ankle Society (AOFAS) scoring system.

Results: We evaluated 64 patients and there were 21 male (%32,8) and 43 female (%67,2) patients. Mean age was 47,41±9.80 (21-74). Mean follow-up period was 53.25±19.18 (24-93) months. 34 patients (%53,1) were operated from right side while 30 patients (%46,9) from left. Mean HVA angle was 33,11±3,39 changed to 14,59±1,8 in Group 1, while these changes were 33,85±3,58 to 14,11±1,91 in Group 2. Mean IMA was 11,43±1,3 changed to 7,76±1,5 in Group 1, while these changes were 11,7±1,3 to 7,74±1,56 in Group 2. Mean AOFAS score was 50,03±8,09 changed to 90,35±6,75 in Group 1, while mean AOFAS score was 49,78±8,96 changed to 90,26±6,59 in Group 2.

Conclusion: Modified Chevron osteotomy appears to be a good surgical method for patients with hallux valgus deformity, which is better in both middle and long term, in terms of patient satisfaction

References

  • 1. Perera AM, Mason L, Stephens MM. The pathogenesis of hallux valgus. J Bone Joint Surg Am. 2011 Sep 7;93(17):1650-1661.
  • 2. Coughlin MJ, Jones CP. Hallux valgus: demographics, etiology, and radiographic assessment. Foot Ankle Int. 2007 Jul;28(7):759-777.
  • 3.Coughlin MJ. Hallux Valgus. J Bone Joint Surg Am.1996; 78(6): 932-966.
  • 4. Robinson AH, Limbers JP. Modern concepts in the treatment of hallux valgus. J Bone Joint Surg Br. 2005 Aug; 87(8): 1038-1045.
  • 5. Schneider W, Aigner N, Pinggera O, Knahr K. Chevron osteotomy in hallux valgus. Ten-year results of 112 cases. J Bone Joint Surg Br. 2004 Sep;86(7):1016-20.
  • 6.Austin DW, Leventen EO. A new osteotomy for hallux valgus: a horizontally directed "V" displacement osteotomy of the metatarsal head for hallux valgus and primus varus. Clin Orthop Relat Res. 1981 Jun;(157):25-30.
  • 7. Toepfer A, Harrasser N, Lenze F, Pohlig F, von Eisenhart-Rothe R. Current concepts in diagnostics and treatment of hallux valgus deformity. MMW Fortschr Med. 2015 Jun 11;157(11):37-40.
  • 8. Hart ES, deAsla RJ, Grottkau BE. Current concepts in the treatment of hallux valgus.Orthop Nurs. 2008 Sep-Oct;27(5):274-80; quiz 281-2.
  • 9.Tai CC, Ridgeway S, Ramachandran M, Ng VA, Devic N, Singh D. Patient expectations for hallux valgus surgery. J Orthop Surg (Hong Kong). 2008 Apr;16(1):91-5.
  • 10. Lindgren U, Turan I: A new operation for hallux valgus. Clin Orthop Relat Res. 1983 May; (175):179–183.
  • 11.Velkes S, Ganel A, Nagris B, Lokiec F. Chevron osteotomy in the treatment of hallux valgus.J Foot Surg. 1991 May-Jun;30(3):276-8.
  • 12.Horne G, Tanzer T, Ford M. Chevron osteotomy for the treatment of hallux valgus.Clin Orthop Relat Res. 1984 Mar;(183):32-6.
  • 13.Johnson KA, Cofield RH, Morrey BF. Chevron osteotomy for Hallux Valgus. Clin Orthop Relat Res.1979 Jul-Aug; (142):44-47.
  • 14. Zimmer TJ, Johnson KA, Klassen RA. Treatment of hallux valgus in adolescents by the chevron osteotomy. Foot Ankle. 1989 Feb;9(4):190-3.
  • 15.Okuda R, Kinoshita M, Morikawa J, Yasuda T, Abe M. Proximal metatarsal osteotomy: relation between 1- to greater than 3-years results.Clin Orthop Relat Res. 2005 Jun;(435):191-6.
  • 16.Veri JP, Pirani SP, Claridge R. Crescentic proximal metatarsal osteotomy for moderate to severe hallux valgus: a mean 12.2 year follow-up study. Foot Ankle Int. 2001 Oct;22(10):817-22.
  • 17.Sammarco GJ, Idusuyi OB. Complications after surgery of the hallux. Clin Orthop Relat Res. 2001 Oct;(391):59-71.
  • 18. Lewis RJ, Feffer HL. Modified chevron osteotomy of the first metatarsal. Clin Orthop Relat Res. 1981 Jun;(157):105-9.
  • 19.Horne G, Tanzer T, Ford M. Chevron osteotomy for the treatment of hallux valgus. Clin Orthop Relat Res. 1984 Mar;(183):32-6.
  • 20.Lillich JS, Baxter DE. Bunionectomies and related surgery in the elite female middle-distance and marathon runner. Am J Sports Med. 1986 Nov-Dec;14(6):491-3.
  • 21. Grill F, Hetherington V, Steinböck G, Altenhuber J. Experiences with the chevron (V-)osteotomy on adolescent hallux valgus. Arch Orthop Traum Surg.1986;106(1):47-51.
  • 22.Klosok JK, Pring DJ, Jessop JH, Maffulli N. Chevron or Wilson metatarsal osteotomy for hallux valgus. A prospective randomised trial. J Bone Joint Surg Br. 1993 Sep;75(5):825-9.
  • 23.Kinnard P, Gordon D. A Comparison between Chevron and Mitchell Osteotomies for Hallux Valgus. Foot Ankle. 1984 Mar-Apr;4(5):241-3.
  • 24. Meier PJ, Kenzora JE. The risks and benefits of distal first metatarsal osteotomies. Foot Ankle. 1985 Aug;6(1):7-17.

Details

Primary Language Turkish
Subjects Medicine
Journal Section Araştırma Makaleleri
Authors

Barış YILMAZ> (Primary Author)
İSTANBUL FATİH SULTAN MEHMET SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
Türkiye


Cem ÇOPUROĞLU This is me
TRAKYA ÜNİVERSİTESİ, TIP FAKÜLTESİ
Türkiye


Mert ÖZCAN This is me
TIP FAKÜLTESİ
Türkiye


Mert ÇİFTDEMİR>
TIP FAKÜLTESİ
Türkiye


Kağan Volkan ÜNVER This is me
İnegöl Devlet Hastanesi
Türkiye


Nurettin HEYBELİ This is me
TIP FAKÜLTESİ
Türkiye

Publication Date September 1, 2019
Application Date September 30, 2018
Acceptance Date October 26, 2018
Published in Issue Year 2019, Volume 26, Issue 3

Cite

Vancouver Yılmaz B. , Çopuroğlu C. , Özcan M. , Çiftdemir M. , Ünver K. V. , Heybeli N. Halluks Valgus tedavisinde modifiye chevron osteotomisi uygulamalarımızın orta ve uzun dönem sonuçları. SDÜ Tıp Fakültesi Dergisi. 2019; 26(3): 306-311.

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