Skip to main content

Advertisement

SpringerLink
Log in

Comparison of open lateral release and transarticular lateral release in distal chevron metatarsal osteotomy for hallux valgus correction

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to investigate the difference in clinical and radiographic outcomes between conventional open lateral soft tissue release (OLSTR) and transarticular lateral soft tissue release (TLSTR) in patients undergoing distal chevron metatarsal osteotomy (DCMO) for hallux valgus (HV) correction.

Methods

This study included weight-bearing anteroposterior radiographs of 138 patients (185 feet) with HV that underwent DCMO and Akin phalangeal osteotomy at a mean age of 51.7 years (21–74) with a mean 26 months of follow-up between June 2004 and June 2010. Patients were classified into two groups: OLSTR as group 1 (84 feet) and TLSTR as group 2 (101 feet). We evaluated clinical and radiographic outcomes between the two groups using the American Orthopaedic Foot and Ankle Society hallux score, visual analogue scale pain score, hallux valgus angle, intermetatarsal angle and complications, pre- and post-operatively.

Results

There were no significant differences between the two groups except for post-operative complications such as first metatarsophalangeal joint (MTPJ) stiffness (group 1) and post-operative hallux varus (group 2).

Conclusions

Clinical and radiographic outcomes between OLSTR and TLSTR in HV correction using DCMO were not significantly different except for post-operative limitation of motion of the first MTPJ and hallux varus tendency. Different precautions should be taken into account when choosing the type of lateral soft tissue release due to possible complications associated with each technique.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Granberry WM, Hickey CH (1995) Hallux valgus correction with metatarsal osteotomy: effect of a lateral distal soft tissue procedure. Foot Ankle Int 16:132–138

    Article  PubMed  CAS  Google Scholar 

  2. Lee H-J, Chung J-W, Chu I-T, Kim Y-C (2010) Comparison of distal chevron osteotomy with and without lateral soft tissue release for the treatment of hallux valgus. Foot Ankle Int 31:291–295. doi:10.3113/FAI.2010.0291

    Article  PubMed  Google Scholar 

  3. Lee W-C, Kim Y-M (2007) Correction of hallux valgus using lateral soft-tissue release and proximal Chevron osteotomy through a medial incision. J Bone Joint Surg Am 89(Suppl 3):82–89. doi:10.2106/JBJS.G.00483

    Article  PubMed  Google Scholar 

  4. O’Donnell T, Hogan N, Solan M, Stephens MM (2010) Correction of severe hallux valgus using a basal chevron osteotomy and distal soft tissue release. Foot Ankle Surg 16:126–131. doi:10.1016/j.fas.2009.08.002

    Article  PubMed  Google Scholar 

  5. Coughlin MJ, Grimes S (2005) Proximal metatarsal osteotomy and distal soft tissue reconstruction as treatment for hallux valgus deformity. Keio J Med 54:60–65

    Article  PubMed  Google Scholar 

  6. Bai LB, Lee KB, Seo CY et al (2010) Distal chevron osteotomy with distal soft tissue procedure for moderate to severe hallux valgus deformity. Foot Ankle Int 31:683–688. doi:10.3113/FAI.2010.0683

    Article  PubMed  Google Scholar 

  7. Chen YJ, Hsu RW, Shih HN et al (1996) Distal chevron osteotomy with intra-articular lateral soft-tissue release for treatment of moderate to severe hallux valgus deformity. J Formos Med Assoc 95:776–781

    PubMed  CAS  Google Scholar 

  8. Potenza V, Caterini R, Farsetti P et al (2009) Chevron osteotomy with lateral release and adductor tenotomy for hallux valgus. Foot Ankle Int 30:512–516. doi:10.3113/FAI.2009.0512

    Article  PubMed  Google Scholar 

  9. Panchbhavi VK, Rapley J, Trevino SG (2011) First web space soft tissue release in bunion surgery: functional outcomes of a new technique. Foot Ankle Int 32:257–261. doi:10.3113/FAI.2011.0257

    Article  PubMed  Google Scholar 

  10. Peterson DA, Zilberfarb JL, Greene MA, Colgrove RC (1994) Avascular necrosis of the first metatarsal head: incidence in distal osteotomy combined with lateral soft tissue release. Foot Ankle Int 15:59–63

    Article  PubMed  CAS  Google Scholar 

  11. Kuhn MA, Lippert FG 3rd, Phipps MJ, Williams C (2005) Blood flow to the metatarsal head after chevron bunionectomy. Foot Ankle Int 26:526–529

    PubMed  Google Scholar 

  12. Easley ME, Kelly IP (2000) Avascular necrosis of the hallux metatarsal head. Foot Ankle Clin 5:591–608

    PubMed  CAS  Google Scholar 

  13. Malal JJG, Shaw-Dunn J, Kumar CS (2007) Blood supply to the first metatarsal head and vessels at risk with a chevron osteotomy. J Bone Joint Surg Am 89:2018–2022. doi:10.2106/JBJS.F.01030

    Article  PubMed  Google Scholar 

  14. Schneider W, Aigner N, Pinggera O, Knahr K (2004) Chevron osteotomy in hallux valgus. Ten-year results of 112 cases. J Bone Joint Surg Br 86:1016–1020

    Article  PubMed  CAS  Google Scholar 

  15. Siclari A, Decantis V (2009) Arthroscopic lateral release and percutaneous distal osteotomy for hallux valgus: a preliminary report. Foot Ankle Int 30:675–679. doi:10.3113/FAI.2009.0675

    Article  PubMed  Google Scholar 

  16. Lui TH, Chan KB, Chan LK (2010) Endoscopic distal soft-tissue release in the treatment of hallux valgus: a cadaveric study. Arthroscopy 26:1111–1116. doi:10.1016/j.arthro.2009.12.027

    Article  PubMed  Google Scholar 

  17. Leemrijse T, Valtin B, Besse J-L (2008) Hallux valgus surgery in 2005. Conventional, mini-invasive or percutaneous surgery? Uni- or bilateral? Hospitalisation or one-day surgery? Rev Chir Orthop Reparatrice Appar Mot 94:111–127. doi:10.1016/j.rco.2007.04.006

    Article  PubMed  CAS  Google Scholar 

  18. Oliva F, Longo UG, Maffulli N (2009) Minimally invasive hallux valgus correction. Orthop Clin North Am 40:525–530, x. doi:10.1016/j.ocl.2009.06.005

    Google Scholar 

  19. Stamatis ED, Huber MH, Myerson MS (2004) Transarticular distal soft-tissue release with an arthroscopic blade for hallux valgus correction. Foot Ankle Int 25:13–18

    PubMed  Google Scholar 

  20. Asunción J, Poggio D (2012) Transmetatarsal lateral release in hallux valgus surgery: technical tip. Foot Ankle Int 33:844–847. doi:10.3113/FAI.2012.0844

    Article  PubMed  Google Scholar 

  21. Choi YR, Lee HS, Jeong JJ et al (2012) Hallux valgus correction using transarticular lateral release with distal chevron osteotomy. Foot Ankle Int 33:838–843. doi:10.3113/FAI.2012.0838

    Article  PubMed  Google Scholar 

  22. Shima H, Okuda R, Yasuda T et al (2009) Radiographic measurements in patients with hallux valgus before and after proximal crescentic osteotomy. J Bone Joint Surg Am 91:1369–1376. doi:10.2106/JBJS.H.00483

    Article  PubMed  Google Scholar 

  23. Mann RA (1990) Decision-making in bunion surgery. Instr Course Lect 39:3–13

    PubMed  CAS  Google Scholar 

  24. Agrawal Y, Desai A, Mehta J (2011) Lateral sesamoid position in hallux valgus: correlation with the conventional radiological assessment. Foot Ankle Surg 17:308–311. doi:10.1016/j.fas.2011.01.001

    Article  PubMed  Google Scholar 

  25. Lin I, Bonar SK, Anderson RB, Davis WH (1996) Distal soft tissue release using direct and indirect approaches: an anatomic study. Foot Ankle Int 17:458–463

    Article  PubMed  CAS  Google Scholar 

  26. Sammarco VJ (2008) Surgical correction of moderate and severe hallux valgus: proximal metatarsal osteotomy with distal soft-tissue correction and arthrodesis of the metatarsophalangeal joint. Instr Course Lect 57:415–428

    PubMed  Google Scholar 

  27. Saltzman CL, Aper RL, Brown TD (1997) Anatomic determinants of first metatarsophalangeal flexion moments in hallux valgus. Clin Orthop Relat Res 339:261–269

    Google Scholar 

  28. Pochatko DJ, Schlehr FJ, Murphey MD, Hamilton JJ (1994) Distal chevron osteotomy with lateral release for treatment of hallux valgus deformity. Foot Ankle Int 15:457–461

    Article  PubMed  CAS  Google Scholar 

  29. Mann RA, Rudicel S, Graves SC (1992) Repair of hallux valgus with a distal soft-tissue procedure and proximal metatarsal osteotomy. A long-term follow-up. J Bone Joint Surg Am 74:124–129

    PubMed  Google Scholar 

  30. Resch S, Stenström A, Reynisson K, Jonsson K (1994) Chevron osteotomy for hallux valgus not improved by additional adductor tenotomy. A prospective, randomized study of 84 patients. Acta Orthop Scand 65:541–544

    Article  PubMed  CAS  Google Scholar 

  31. Sammarco GJ, Conti SF (1993) Proximal Chevron metatarsal osteotomy: single incision technique. Foot Ankle 14:44–47

    Article  PubMed  CAS  Google Scholar 

  32. Schneider W (2012) Influence of different anatomical structures on distal soft tissue procedure in hallux valgus surgery. Foot Ankle Int 33:991–996. doi:10.3113/FAI.2012.0991

    Article  Google Scholar 

  33. Choi KJ, Lee HS, Yoon YS et al (2011) Distal metatarsal osteotomy for hallux varus following surgery for hallux valgus. J Bone Joint Surg Br 93:1079–1083. doi:10.1302/0301-620X.93B8.26430

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Pungnap 2-dong, Songpa-gu, Seoul, South Korea

    Ji Yong Ahn, Ho Seong Lee, Jin Sam Kim & Dong Kyo Seo

  2. Active Podiatry, O’connor, WA, Australia

    Hannah Chun

  3. Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, Seoul, South Korea

    Young Rak Choi

  4. Department of Orthopaedic Surgery, Ulsan University Hospital, University of Ulsan, College of Medicine, Ulsan, South Korea

    Sang Woo Kim

Authors
  1. Ji Yong Ahn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ho Seong Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hannah Chun
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jin Sam Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dong Kyo Seo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Young Rak Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sang Woo Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ho Seong Lee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ahn, J.Y., Lee, H.S., Chun, H. et al. Comparison of open lateral release and transarticular lateral release in distal chevron metatarsal osteotomy for hallux valgus correction. International Orthopaedics (SICOT) 37, 1781–1787 (2013). https://doi.org/10.1007/s00264-013-2023-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-013-2023-1

Keywords

Search

Navigation