The definitive guideline for the osteotomy technique or the superiority of a particular surgical approach for severe hallux valgus correction remains elusive. Here, we investigated the clinical and radiographic outcomes following modified distal chevron osteotomy coupled with proximal Akin osteotomy to correct severe hallux valgus. A prospective cohort study was performed on 45 patients (62 feet) diagnosed with severe hallux valgus, undergoing the modified distal chevron osteotomy technique described in this study, combined with proximal Akin osteotomy. The radiographic variables: hallux valgus angle and intermetatarsal angle, were measured, and the American Orthopaedic Foot and Ankle Association scoring system was used to assess the clinical curative effect at six weeks and one-year intervals following surgery. Compared to the preoperative assessments, the hallux valgus and intermetatarsal angles were significantly decreased, and the American Orthopaedic Foot and Ankle Association score was increased markedly in both postoperative follow-ups. The difference between the variables was comparable at the six-week and one-year postoperative reassessments. No severe surgical complications or recurrences were observed. The combined use of modified distal chevron osteotomy and proximal Akin osteotomy demonstrated favorable therapeutic outcomes and satisfactory surgical correction. The above-mentioned surgical technique can be, therefore, recommended to correct the severe hallux valgus deformity. Level of Clinical Evidence: 2.
Keywords: akin osteotomy; hallux valgus angle; intermetatarsal angle; modified chevron osteotomy; severe hallux valgus.
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