Mahmut GÜNAY, Abdulhamit MISIR, Mustafa ÖZÇAMDALLI, Turan KIZKAPAN, Erdal UZUN, Mahmut MUTLU

Halluks valgus tedavisinde Lindgren-Turan ve Chevron osteotomilerinin klinik ve radyolojik sonuçlarının karşılaştırılması

Amaç: Bu çalışmanın amacı Halluks valgus tedavisinde Lindgren-Turan ve Chevron osteotomilerinin klinik ve radyolojik sonuçlarını değerlendirmektir.Gereç ve Yöntem: Bu çalışmaya Haziran 2010 ile Haziran 2014 arasında Lindgren-Turan (Grup 1, n = 16 hasta, 20 ayak) veya Chevron (Grup 2, n = 18 hasta, 20 ayak) osteotomisi uygulanan 34 halluks valguslu hasta dahil edildi. HVA, IMA ve DMAA değişiklikleri ve birinci metatars kısalığı basarak AP radyografilerinde değerlendirildi. Klinik değerlendirmede Amerikan Ortopedik Ayak ve Ayak Bileği Derneği (AOFAS) skoru kullanıldı. Ayrıca hastaların sağlıkla ilişkili yaşam kalitesinin değerlendirilmesinde EQ-5D skoru kullanıldı. Ameliyat öncesi ve sonrası hastaların subjektif ağrı skorlarını değerlendirmek için görsel analog skala (VAS) kullanıldı.Bulgular: Lindgren-Turan ve Chevron osteotomi grupları arasında preoperatif ve postoperatif HVA, IMA ve DMAA ve ilk metatarsusun kısalması açısından anlamlı fark yoktu. Ayrıca AOFAS ve EQ-5D skorları açısından iki grup arasında anlamlı fark yoktu.Sonuç: Hem Lindgren-Turan hem de Chevron osteotomileri, halluks valgusunun cerrahi tedavisinde faydalı tekniklerdir. Yeterli ağrı kontrolü, osteotomi kaynaması, deformite düzeltmesi ve yüksek hasta memnuniyet oranları iki teknikle de sağlanabilir.

Comparison of clinical and radiological outcomes of Lindgren-Turan and Chevron osteotomies in the treatment of Hallux valgus

Purpose: The aim of this studywas to evaluate clinical and radiological outcomes of Lindgren-Turan and Chevron osteotomies in the treatment of hallux valgus.Materials and Methods: This study included 34 patients with hallux valgus who underwent Lindgren-Turan (Group 1, n=16 patients, 20 feet) or Chevron (Group 2, n=18 patients, 20 feet) osteotomy between June 2010 and June 2014. HVA, IMA and DMAA changes and first metatarsal shortening was evaluated in weight bearing AP radiographs. American Orthopedic Foot and Ankle Society (AOFAS) score was used in the clinical evaluation. Also, EQ-5D score was used in the evaluation of health-related quality of life of patients. Visual analog scale (VAS) was used to evaluate subjective pain scores of patients preoperatively and postoperatively.Results: There was no significant difference between Lindgren-Turan and Chevron osteotomy groups regarding preoperative and postoperative HVA, IMA and DMAA and shortening of the first metatarsus). Also, there was no significant differences between two groups regarding AOFAS and EQ-5D scores.Conclusion: Both Lindgren-Turan and Chevron osteotomies are useful techniques in the surgical treatment of hallux valgus. Adequate pain relief, osteotomy union, deformity correction and high patient satisfaction rates can be achieved by two techniques.

Keywords:

Hallux valgus, osteotomy, outcome,

PDF

___

1. Coughlin MJ, Jones CP. Hallux valgus: demographics, etiology and radiographic assessment. Foot Ankle Int. 2007;28:759-77.
2. Unal AM, Baran O, Uzun B, Turan AC. Comparison of screw-fixation stabilities of first metatarsal shaft osteotomies: a biomechanical study. Acta Orthop Traumatol Turc. 2010;44:70-5.
3. Matthews M, Klein E, Acciani A, Sorensen M, Weil L Jr, Weil LS Sr, Fleischer A. Correlation of preoperative radiographic severity with disability and symptom severity in hallux valgus. Foot Ankle Int. 2019;40:923- 8.
4. Coughlin MJ.; Anderson RB. Mann’s Surgery of the Foot and Ankle. 2014;(1):155-321.
5. Uygur E, Özkan NK, Akan K, Cift H. A comparison of Chevron and Lindgren-Turan osteotomy techniques in hallux valgus surgery: a prospective randomized controlled study. Acta Orthop Traumatol Turc. 2016;50:255–61.
6. Rockett MS, Goss LR. Midshaft first ray osteotomies for hallux valgus. Clin Podiatr Med Surg, 2005;22:169- 95.
7. Coetzee JC, Rippstein P. Surgical strategies: scarf osteotomy for hallux valgus. Foot Ankle Int. 2007;28:529-35.
8. Mann RA, Donatto KC. The chevron osteotomy: a clinical and radiographic analysis. Foot Ankle Int. 1997;18:255-61.
9. Hirvensalo E, Böstman O, Törmälä P, Vain- ionpää S, Rokkanen P. Chevron osteotomy fixed with absorbable polyglycolide pins. Foot Ankle. 1991;11:212-8.
10. Pring DJ, Coombes RRH, Closok JK. Chevron or Wilson Osteotomy: A comparision and fol- low-up (abstract). J. Bone Joint Surg Am 1985;67:671-2.
11. Yücel İ, Özturan K, Atam C. Results of LindgrenTuran operation in hallux valgus. Düzce Medical Journal. 2010;12:63-8.
12. Saro C, Andrén B, Wildemyr Z, Felländer-Tsai L. Outcome after distal metatarsal osteotomy for hallux valgus: a prospective randomized controlled trial of two methods. Foot Ankle Int 2007;28:778-87.
13. Brodsky JW. The Lindgren and chevron osteotomies were not different in repair of hallux valgus. J Bone Joint Surg Am. 2008;90:450.
14. Bostan B, Gunes T, Erdem M, Ascı M, Sen C, Erdogan H. Comparison of modified Lindgren-Turan operation and proximal crescentic osteotomy combined with distal soft tissue procedure in the treatment of hallux valgus. Joint Dis Rel Surg. 2008;19:61-5.
15. Kaptan AY, Çavuşoğlu AT, Tokgöz MA, Elma T, Yapar A. Distal oblique metatarsal osteotomy technique in hallux valgus deformity: Clinical and radiological results. Jt Dis Relat Surg. 2020;31:88-94.
16. Rothwell M, Pickard J. The chevron osteotomy and avascular necrosis. Foot (Edinb). 2013;23:34-8.
17. Meier PJ, Kenzora JE. The risks and benefits of distal first metatarsal osteotomies. Foot Ankle. 1985;6:7-17.
18. Joseph TN, Mroczek KJ. Decision making in the treatment of hallux valgus. Bull NYU Hosp Jt Dis. 2007;65:19–23.
19. Hsieh MO, Kagle JD. Understanding patient satisfaction and dissatisfaction with health care. Health Soc Work. 1991;16:281–290.
20. Tai CC, Ridgeway S, Ramachandran M, Ng VA, Devic N, Singh D. Patient expectations for hallux valgus surgery. J Orthop Surg (Hong Kong). 2008;16:91-5.
21. Konerding U, Moock J, Kohlmann T. The classification systems of the EQ-5D, the HUI II and the SF6D: what do they have in common? Qual Life Res. 2009;18:1249-61.
22. Esemenli T, Güven O, Yalçın S. Halluks valgus cerrahi tedavisinde Lindgren ve Turan ameliyatı ile aldığımız sonuçlar. Acta Orthop Traum Turc. 1991;25:8-12.
23. Erturer E, Aksoy B, Bek S, Toker S, Ozturk I. Radiographic and functional results of the LindgrenTuran operation in the treatment of hallux valgus. Acta Orthop Traum Turc. 2004;38:125-9.