Distal chevron osteotomies enhance patient-reported outcomes for all severity grades of hallux valgus: a cohort study
DOI:
https://doi.org/10.2340/17453674.2025.44750Keywords:
Chevron osteotomy, Foot and ankle, Hallux valgusAbstract
Background and purpose: There is limited data on the functional outcome after hallux valgus (HV) surgery. Our study aims to assess 1-year postoperative patient-reported outcomes (PROMs) after a chevron osteotomy (CO) for 3 severity levels, the number of additional surgical interventions during the index procedure, and the association between the presence or absence of internal fixation and PROMs.
Methods: This is a prospective cohort from the Swedish register for foot and ankle surgery (Swefoot), including patients treated with primary CO between 2014 and 2021. HV deformities were classified into 3 severity grades. Preoperative demographic data, additional surgical procedures, and PROMs (Self-reported Foot and Ankle Score [SEFAS] and the EuroQol 5-dimensional 3-level scale [EQ-5D-3L]) were collected both pre- and 1 year post-surgery.
Results: The study included 2,259 HV feet (2,123 patients, mean age 55 (range 15–90) years, 83% women) The mean SEFAS score increased by 11 (95% confidence interval [CI] 9.8–11.8) points from the pre-surgery assessment to the 1-year post-surgery follow-up for the mild HV group, by 9 (CI 9.0–10.0) for the moderate, and by 9 (CI 7.5–9.8) for the severe group. EQ-5D-3L also improved in all 3 groups. For all 3 HV grades, patients treated with fixation demonstrated no statistically significant improvements in SEFAS scores compared with those without fixation.
Conclusion: Distal chevron osteotomy improved 1-year patient-reported outcomes across all grades of hallux valgus. Improvements were observed both with and without internal fixation. In more severe cases, additional procedures such as Akin osteotomy and distal soft tissue release were more commonly performed.
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Copyright (c) 2025 Cyrus D Brodén, Ann-Charlott Söderpalm, Eva Tengman, Nils P Hailer, Maria C Cöster
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