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Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy

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Published on: February 17, 2023

Modified biplanar chevron osteotomy.

Nuno M Corte-Real¹, Rodrigo M Moreira

¹Hopital de Saint Louis-Hospital de Curry Cabral, Orthopaedic Surgery, Rua da Beneficência 8, Lisboa 1500-461 Lisboa, Portugal. nc-r@netcabo.pt

Foot & Ankle International

|December 17, 2009

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This study shows that a modified biplanar chevron osteotomy effectively corrects increased distal metatarsal articular angle (DMAA) in hallux valgus patients. The procedure yields good functional and radiographic outcomes, improving alignment and patient satisfaction.

Area of Science:

Orthopedic surgery
Foot and ankle reconstruction
Biomechanical correction

Background:

Surgical correction of hallux valgus with increased distal metatarsal articular angle (DMAA) is crucial for joint congruence.
This study reports outcomes of a specific surgical technique for DMAA correction.

Purpose of the Study:

To evaluate the efficacy of a modified biplanar chevron osteotomy for correcting increased DMAA in hallux valgus.
To assess clinical and radiographic results following the surgical procedure.

Main Methods:

A modified biplanar chevron osteotomy was performed on 23 feet (13 patients) with increased DMAA between 2000 and 2006.
Surgical technique involved a more horizontal plantar cut and a dorsal wedge removal.
Clinical and radiographic evaluations, including AOFAS scores and angular measurements, were conducted at a mean 56-month follow-up.

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Main Results:

The mean AOFAS score improved to 87, indicating good functional results.
Significant improvements were observed in angular deformities: hallux valgus angle (28° to 14°), intermetatarsal angle (12° to 7°), and DMAA (20° to 7°).
One patient experienced minimally symptomatic avascular necrosis (AVN) of the metatarsal head; otherwise, patient satisfaction was high.

Conclusions:

The modified biplanar chevron osteotomy is a suitable treatment for symptomatic hallux valgus with increased DMAA.
The procedure achieves favorable clinical and radiographic outcomes, effectively correcting angular deformities.