Volume 9 Issue 2
Sesamoid Bone Reduction in Hallux Valgus: Comparing Radiological Outcomes of Hallux Valgus Following Distal Chevron Osteotomy and Modified McBride Procedure
Po-Han Su,Chung-Wei Lin,Cheng-Hung Chiang,Wei-Chih Wang,Chen-Wei Yeh,Hsien-Te Chen,Yi-Chin Fong andChien-Chung Kuo
1Department of Orthopedic Surgery, China Medical University Hospital, China Medical University, No. 2, Xueshi Rd., North Dist., Taichung City 404, Taiwan
2Department of Orthopedic Surgery, China Medical University Beigang Hospital, China Medical University, No. 123, Xinde Rd., Beigang Township, Yunlin County 651, Taiwan
3Department of Sports Medicine, College of Health Care, China Medical University, No. 91, Xueshi Rd., North Dist., Taichung City 404, Taiwan
4Spine Center, China Medical University Hospital, China Medical University, No. 2, Xueshi Rd., North Dist., Taichung City 404, Taiwan
5Department of Orthopedic Surgery, School of Medicine, China Medical University, No. 91, Xueshi Rd., North Dist., Taichung City 404, Taiwan
Author to whom correspondence should be addressed.
Abstract
Background: Hallux valgus is a common forefoot disorder with hundreds of proposed management techniques. Distal chevron osteotomy with a modified McBride procedure has been traditionally recommended for mild hallux valgus because of its simple and less invasive nature with fewer complications, faster recovery, and reliable outcomes. In recent years, the indications for this procedure have expanded to include hallux valgus with severe deformities. This study aims to compare the radiographic outcomes of the surgical treatment for moderate versus severe hallux valgus patients from the perspective of sesamoid bone reduction. Materials and Methods: A retrospective review of medical records identified 99 feet from 94 patients that were treated with distal chevron osteotomy with a modified McBride procedure. These feet were divided by the preoperative hallux valgus angle and intermetatarsal angle into the moderate and severe groups. Results: Postoperative radiographic parameters significantly improved in both groups after treatment, indicating adequate deformity correction. Improvement in the sesamoid position was better in the moderate group compared to that in the severe group. The recurrence rate in the severe group was higher than that in the moderate group without statistical significance. Conclusions: Based on the radiographic results of the postoperative position following sesamoid reduction, the distal chevron osteotomy with a modified McBride procedure is effective for treating moderate hallux valgus deformities. However, this treatment strategy may be associated with a higher recurrence rate in cases of severe hallux valgus deformity. A complete reduction in the sesamoids should be emphasized during the management of severe hallux valgus deformity.
Keywords: hallux valgus; distal chevron osteotomy with a modified McBride procedure; sesamoid reduction
