Plantar loading after chevron osteotomy combined with postoperative physical therapy

Area of Science:

• Orthopedic surgery
• Biomechanics
• Physical therapy

Background:

• Pedobarographic studies show reduced great toe and first metatarsal head loading post-hallux valgus surgery.
• Investigating the impact of rehabilitation on first ray weightbearing after chevron osteotomy is crucial.

Purpose of the Study:

• To evaluate if a postoperative rehabilitation program enhances first ray weightbearing after chevron osteotomy for hallux valgus.
• To assess the effectiveness of a multimodal rehabilitation approach.

Main Methods:

• 29 patients with hallux valgus underwent chevron osteotomy and a rehabilitation program (mobilization, manual therapy, strengthening, gait training).
• Plantar pressure distribution (force, contact area, force-time integral), AOFAS score, ROM, and radiographs were assessed preoperatively and at 1-year follow-up.
• Statistical analysis using Student's t-test (p < 0.05).

Main Results:

• Significant improvements in great toe maximum force, contact area, and force-time integral (p < 0.05).
• Positive trends in first metatarsal head maximum force and force-time integral (p=0.068, p=0.055).
• Marked improvement in AOFAS score (61 to 94) and significant reduction in hallux valgus (31° to 9°) and intermetatarsal angles (14° to 6°).

Conclusions:

• Postoperative physical therapy and gait training following chevron osteotomy improve great toe and first ray weightbearing.
• The rehabilitation regimen contributes to the restoration of physiological gait patterns.
• This approach is beneficial for patients undergoing surgical correction for hallux valgus.