Percutaneous distal metatarsal osteotomy versus distal chevron osteotomy for correction of mild-to-moderate hallux valgus deformity

A lot of procedures were described for managing hallux valgus deformity. Percutaneous metatarsal osteotomies have received increasing recognition in the previous decade. The proposed benefits revolve primarily around the shorter surgical time, lower incidence of complications, and higher patient satisfaction. However, there is insufficient evidence to determine whether this technique is comparable to traditional open approaches. A total of 64 consecutive feet (53 patients) with mild-to-moderate symptomatic hallux valgus were randomly assigned into two groups to compare the results of percutaneous distal metatarsal osteotomy (group I, 31 feet) and distal chevron osteotomy (group II, 33 feet). All patients were clinically assessed using the American Orthopedic Foot and Ankle Society (AOFAS) scoring system. Radiographical assessment was done using the hallux valgus angle (HVA) and intermetatarsal angle (IMA). The mean correction of HVA and IMA achieved in group I was 14.4A degrees and 4.8A degrees, respectively, while in group II, it was 13.1A degrees and 3.9A degrees, respectively. The mean AOFAS score improved from a pre-operative of 44.6 points to 90.2 points in group I, and from 47.5 points to 87.7 points in group II. In group I, 26/29 patients (89.6 %) were happy with the cosmetic results of the surgery, compared to 20/31 patients (64.5 %) in group II. The results of this study support the idea that percutaneous distal metatarsal osteotomy yields good functional and radiological result and is associated with a high degree of postoperative patient satisfaction.