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journal article Mar 01, 2007

Bunion Surgery Using Locking-Plate Fixation of Proximal Metatarsal Chevron Osteotomies

James W. Gallentine James K. DeOrio Matthew J. DeOrio
Foot & Ankle International Vol. 28 No. 3 pp. 361-368 · SAGE Publications
View at Publisher Save 10.3113/fai.2007.0361
Abstract
Background: Symptomatic large hallux valgus deformities commonly require surgical intervention with a proximal metatarsal osteotomy. A number of fixation methods have been described for proximal chevron osteotomies; one of the most recent is locking plates. Methods: We retrospectively reviewed the records of 16 consecutive patients (20 feet) with severe bunion deformities who had locking-plate fixation of proximal chevron osteotomies. Clinical evaluation focused on osteotomy healing, transfer lesions, and hardware-related complications. Preoperative and postoperative radiographic evaluation included the hallux valgus angle (HVA), 1-2 intermetatarsal angle (IMA), medial 1-2 intermetatarsal distance (MIMD; the amount of narrowing of the foot), sesamoid position, first metatarsal elevation, and metatarsal length change. A postoperative American Orthopaedic Foot and Ankle Society (AOFAS) score was obtained in all patients. Results: The average radiographic improvements were HVA, 16.0 degrees, IMA, 7.6 degrees, and MIMD, 9.0 mm. Sesamoid position improved in 16 of 20 feet. First metatarsal elevation averaged 0.8 degrees, and the average metatarsal shortening was less than 1 mm. The AOFAS score averaged 94.1 points. Two complications were unrelated to plate fixation. Conclusions: The locking plate held alignment and position of the first ray after chevron osteotomy without clinical evidence of transfer lesions or hardware-related symptoms. Locking plates may improve stability of the proximal metatarsal after a chevron osteotomy for correction of hallux valgus.
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Cited By
46
Current Concepts Review: Hallux Valgus Part II: Operative Treatment

Mark E Easley, Hans-Joerg Trnka · 2007

Foot & Ankle International
Metrics
46
Citations
38
References
Details
Published
Mar 01, 2007
Vol/Issue
28(3)
Pages
361-368
License
View
Authors
J
James W. Gallentine

Jacksonville, FL

J
James K. DeOrio

Jacksonville, FL

M
Matthew J. DeOrio

Jacksonville, FL

Cite This Article
James W. Gallentine, James K. DeOrio, Matthew J. DeOrio (2007). Bunion Surgery Using Locking-Plate Fixation of Proximal Metatarsal Chevron Osteotomies. Foot & Ankle International, 28(3), 361-368. https://doi.org/10.3113/fai.2007.0361
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