Biomechanical Comparison of Newly Defined Distal Osteotomy and Distal Chevron Osteotomy in Hallux Valgus Surgery

Distal metatarsal chevron osteotomy is widely used in hallux valgus surgery, and many different osteotomy methods have been described in the literature because of its complications, such as nonunion, loss of reduction, and osteolysis. This study aimed to biomechanically compare the newly defined Parmaksızoğlu osteotomy and the distal chevron osteotomy.

A total of 14 sawbone models were divided into two groups, and Parmaksızoğlu and distal chevron osteotomies were performed with the created incision guides. For biomechanical tests, fatigue testing was performed on the samples with 1,000 cycles of axial loading up to 10 N at a 15° angle. Rigidity, dorsal angulation, and deforming force values were recorded.

In the chevron osteotomy group, the average rigidity value of the 1,000th cycle was measured as 3.69 N/mm, the dorsal angulation value was 1.95°, and the average deforming force value was 20.14 N. In the Parmaksızoğlu osteotomy group, the average rigidity value of the 1,000th cycle was measured as 2.28 N/mm, the dorsal angulation value was 2.12°, and the average deforming force value was 26.72 N.

In this study, Parmaksızoğlu osteotomy and chevron osteotomy were compared in terms of rigidity, dorsal angulation, and deforming force, and no statistically significant superiority of one technique over the other was observed. It has been statistically shown that the Parmaksızoğlu osteotomy, which has demonstrated a lower complication rate and a higher American Orthopaedic Foot & Ankle Society score in previous studies, has biomechanically similar features to the distal chevron osteotomy.