Objective To retrospectively evaluate the clinical and X-ray outcomes of Chevron osteotomy combined with soft tissue release in treatment of moderate hallux valgus (HV) deformity. Methods From January 2009 to October 2011, Fifty-four patients with a total of 87 HV feet were operated with use of Chevron osteotomy combined with soft tissue release in our department. The HV angle (HVA) and the first and second intermetatarsal angle (1-2 IMA) were measured on the pre- and postoperative anterior to posterior weight-bearing X-rays of treated feet, and the American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal (MTP-IP) scale were used to evaluate the pre- and post-operative outcomes. Results A total of 38 patients with 56 feet were followed, with a mean 22. 6 months (range 12 to 37 months). The mean age was 42. 5 years (range 26 to 63 years). No postoperative infection and nonunion on the osteotomy site was found at the follow- up time. However, 4 patients with 5 feet (8.9%) had mile weight- bearing and walking pain under the 1 st MTP joint, and 2 patients with 2 feet (3.6%) had recurrence. The mean pre-operative HVA was 32. 3° ± 5. 4°, and was decreased to 17. 5° ±3. 4° (P<0.01). The mean 1-2 IMA was decreased from 14.4° ± 3. 2° to 9. 7° ± 2. 4° (P<0. 01). The mean AOFAS MTP-IP score were improved from 46. 3 ± 5. 7 points to 83. 4 ± 6. 2 points (F<0. 01). For the followed patients, 17 cases (21 feet) reached excellent, good of 15 cases (26 feet), fair of 6 cases (9 feet), wnh an excellent and good rate of 83. 9%. Conclusions Chevron osteotomy combined with soft tissue release in treatment of moderate HV deformity can reach good clinical and radiological outcomes with little complications. However, some patients were found walking and weight-bearing pain under the 1st MTP joint, which might be related with the increase stress on the 1 st MTP joint.%目的 探讨Chevron截骨术结合软组织松解治疗中度足拇外翻畸形的临床及影像学疗效.方法 回顾性研究2009年1月至2011年10月期间采用Chevron截骨术结合软组织松解治疗中度足拇外翻畸形54例(87足),比较术前及术后末次随访时拇外翻角(HVA)和1～2跖骨间角(IMA).根据美国足踝外科协会(AOFAS)足拇趾、跖趾关节、趾间关节评分评估患者功能愈后.结果 有38例(56足)获随访,其中男性7例(11足),女性31例(45足)；平均年龄42.5岁(26～63岁).平均随访22.6个月(12～37个月),无感染和不愈合发生,有4例5足(8.9％)出现负重行走时第一跖趾关节下轻度疼痛,2例2足(3.6％)出现足拇外翻复发.HVA由术前平均32.3°±5.4°减小至术后平均17.5°±3.4°(P＜0.01),1～2 IMA由术前平均14.4°±3.2°减小至术后平均9.7°±2.4°(P＜0.01),AOFAS评分由术前平均46.3±5.7分提高至术后平均83.4±6.2分(P＜0.01).功能评级优21足,良26足,中9足,优良率为83.9％.结论 Chevron截骨术结合软组织松解可显著改善中度足拇外翻患者临床症状,术后影像学角度改女善明显.部分患者术后存在第一跖趾关节下轻度负重疼痛,可能与术后第一跖骨负重增加相关.
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