RESEARCH ARTICLE


Ninety-Degree Chevron Osteotomy for Correction of Hallux Valgus Deformity: Clinical Data and Finite Element Analysis



Charalambos Matzaroglou1, Panagiotis Bougas1, Elias Panagiotopoulos1, Alkis Saridis1, Menelaos Karanikolas*, 2, Dimitris Kouzoudis3
1 Department of Orthopaedic Surgery, University of Patras, Greece
2 Department of Anaesthesiology and Critical Care, University of Patras, Greece
3 Engineering Sciences Department, University of Patras, Greece


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Creative Commons License
© Matzaroglou et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Anaesthesiology and Critical Care, University of Patras, Rion, 26500, Greece; Tel: +30-6977964148; E-mails: kmenelaos@yahoo.com; menelaos.karanikolas@gmail.com


Abstract

Hallux valgus is a very common foot disorder, with its prevalence estimated at 33% in adult shoe-wearing populations. Conservative management is the initial treatment of choice for this condition, but surgery is sometimes needed. The 600 angle Chevron osteotomy is an accepted method for correction of mild to moderate hallux valgus in adults less than 60 years old. A modified 900 angle Chevron osteotomy has also been described; this modified technique can confer some advantages compared to the 600 angle method, and reported results are good. In the current work we present clinical data from a cohort of fifty-one female patients who had surgery for sixty-two hallux valgus deformities. In addition, in order to get a better physical insight and study the mechanical stresses along the two osteotomies, Finite Element Analysis (FEA) was also conducted. FEA indicated enhanced mechanical bonding with the modified 900 Chevron osteotomy, because the compressive stresses that keep the two bone parts together are stronger, and the shearing stresses that tend to slide the two bone parts apart are weaker, compared to the typical 600 technique. Follow-up data on our patient cohort show good or excellent long-term clinical results with the modified 900 angle technique. These results are consistent with the FEA-based hypothesis that a 900 Chevron osteotomy confers certain mechanical advantages compared to the typical 600 procedure.

Keywords: Osteotomy, hallux valgus, finite element analysis.