Treatment of Hallux Valgus by Hammond's Operation and by Modified Chevron Osteotomy

抄録

In the first half of the period from 1975 to 1985 we treated patients with hallux valgus by Hammond's operation, which is a modified Mitchell's operation, and in the latter half by modified chevron osteotomy. Chevron osteotomy, as described by J.R. Corless, is a method in which a V-shaped osteotomy is done with the apex of the V towards the first metatarsophalangeal joint in the saggital plane and the head is slid laterally. In modified chevron osteotomy, as described by J.L. Randall, the contact area of the osteotomy plane is increased and stabilized by the extension of both arms of the V.
Tewnty-five feet were operated on in 17 patients, all female, with arangeof age from 23 to 63 years old (average: 46) . Two of these patients had rheumatoid arthritis and one cerebral palsy. The average duration time of symptoms before operation was 26 months. Six patients were treated with Hammond's operation and 11 with modified chevron osteotomy, with average operation times of 71 minutes and 42 minutes respectively. The time until full weight-bearing was 8 to 12 weeks with the former method and 4 to 6 weeks with the latter.
The average follow-up time was 7 months. Radiologically the intermetatarsal angle was corrected from 16±2° (M±SD) to 11±4° by Hammond's operation and from 13±3° to 11±3 ° by modified chevron osteotomy. Tenderness and pain in walking disappeared or decreased in all of the former cases and in 80% of the latter. Based on the superiority of the operative procedure and length of postoperative care, we concluded that modified chevron osteotomy was a good operation for mild or moderate cases of hallux valgus.