Chevron Osteotomy (for Hallux Valgus)
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Patients with symptomatic Hallux Valgus will have pain predominantly from the medial eminence (though of course not all patients are symptomatic). Pain is classically when in shoe-wear (or more specifically tighter fitting shoe-wear). Surgery in the majority of cases is indicated for pain.
With regards to radiographic criteria a mild Hallux Valgus could be said to be a Hallux Valgus angle (the degree of lateral angulation of the hallux relative to the first ray ) of less than 2o degrees and an inter-metatarsal (IM) angle of less than 11 degrees. A moderate deformity displays a Hallux Valgus angle of 20 to 40 degrees and an Inter-metatarsal angle of 11-18 degrees. A severe deformity a Hallux Valgus angle in excess of 4o degrees and inter-metatarsal angle over 18 degrees.
The Chevron osteotomy is a distal diaphyseal osteotomy which is used for correcting smaller Hallux Valgus deformities and is most successfully used to correct IM angles of less than 15 degrees.
There is debate about the risk of avascular necrosis if the operation is combined with a formal open lateral release. A more limited transarticular lateral soft tissue release can be performed through the medial joint approach and this is usually required to mobilise the osteotomy adequately.
Author:Mark Herron FRCS.
Institution: The Wellington Hospital, London, UK.
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Question 1 of 15
Which one of the following statements is true of the Chevron osteotomy ?CorrectIncorrect
Question 2 of 15
Which one of the following is not a symptom caused or contributed to by Hallux ValgusCorrectIncorrect
Question 3 of 15
Considering the imaging of a Hallux Valgus patient with symptoms which one of the following statements is not true ?CorrectIncorrect
Question 4 of 15
Which one of the following features is not well assessed on a pre-operative X-Rays?CorrectIncorrect
Question 5 of 15
Which one of the following statements is correct about the skin incision for a Chevron osteotomy ?CorrectIncorrect
Question 6 of 15
During the surgical exposure for a Chevron osteotomy once through the skin which of the following steps is the next ?CorrectIncorrect
Question 7 of 15
Once the joint is opened by horizontal capsulotomy the correct next stage is which one of the following ?CorrectIncorrect
Question 8 of 15
Once the Metatarsal head has been fully exposed which of the following steps may not be the next immediate step ?CorrectIncorrect
Question 9 of 15
In performing a Chevron osteotomy which one of the following statements is true of the horizontal osteotomy cut ?CorrectIncorrect
Question 10 of 15
If the Chevron osteotomy does not adequately displace which one of the following steps is incorrect ?CorrectIncorrect
Question 11 of 15
If during screw insertion a fracture occurs through the drilled hole into the joint which one of the following statements is correct ?CorrectIncorrect
Question 12 of 15
Which one of the following statements is true about fixation of the Chevron osteotomy ?CorrectIncorrect
Question 13 of 15
During capsular closure of the Chevron osteotomy which one of the following statements is true?CorrectIncorrect
Question 14 of 15
In the post-operative period which of the following statements is correct ?CorrectIncorrect
Question 15 of 15
With respect to the published results which one of the following statements is correct ?CorrectIncorrect