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Fixation comparison for chevron osteotomies

L A Crosby1, G R Bozarth

  • 1Department of Orthopaedic Surgery, University of Tennessee/Chattanooga Unit 37403, USA.

Foot & Ankle International
|February 14, 1998
PubMed
Summary
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For hallux valgus deformities, this study found no significant difference in patient satisfaction or long-term benefit between chevron osteotomies with Herbert Whipple screw fixation, K-wire fixation, or no fixation. Costs were higher with screw fixation.

Area of Science:

  • Orthopedic surgery
  • Foot and ankle surgery

Background:

  • Hallux valgus deformities are common and can be treated with distal chevron osteotomies.
  • Various fixation methods exist for osteotomies, including K-wires and screws, each with potential benefits and drawbacks.

Purpose of the Study:

  • To compare the outcomes of temporary K-wire fixation, permanent Herbert Whipple screw fixation, and no fixation for distal chevron osteotomies in hallux valgus correction.
  • To evaluate differences in patient satisfaction, operative costs, and anesthesia time among the fixation groups.

Main Methods:

  • A comparative study involving 19 chevron osteotomies in 17 patients with hallux valgus.
  • Patients were divided into three groups: Herbert Whipple screw fixation (6), temporary K-wire fixation (7), and no fixation (6).
  • Outcomes measured included hallux valgus angle improvement, patient satisfaction, anesthesia time, and operative costs, with statistical analysis using the Student's t-test.

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Main Results:

  • Average hallux valgus angle improvement was 9.5° with screw fixation, 6.3° with K-wire fixation, and 7.1° with no fixation; no statistically significant difference was found between groups (P = 0.6).
  • Herbert Whipple screw fixation significantly increased anesthesia time and operative costs compared to no fixation (P < 0.001).
  • No significant differences in patient satisfaction were observed across all groups after an average follow-up of 3.3 years.

Conclusions:

  • This study found no long-term benefit or significant difference in patient satisfaction when comparing temporary or permanent fixation methods versus no fixation for distal chevron osteotomies in hallux valgus.
  • The increased costs associated with Herbert Whipple screw fixation do not appear to be justified by improved patient outcomes or satisfaction.