A Chevron osteotomy is a commonly carried out surgery to manage bunions on the feet. The bunion is the enlargement and a misalignment in the great toe or hallux then may cause the big toe to angle towards the smaller toes. This very often results in a lump at the base of the big toe which might become uncomfortable. There are numerous surgical treatments that can be used to manage a bunion. Each of the procedures carries a variety of indications as to exactly who it will be the best option for. Having a Chevron osteotomy, the foot and ankle orthopaedic or podiatric surgeon cuts a “V” at the end of the long bone leading to the great toe (the metatarsal) after which turns that cut portion of the bone to push back the big toe.
Typically the indications for the Chevron osteotomy are typically for younger individuals who have no osteoarthritis in the hallux joint and the amount of the bunion is regarded as mild to moderate. It is often the procedure of choice for young sports athletes, although elderly people having a moderate deformity can do well with this operation. The key prerequisite is a hallux joint that is congruent and with no arthritis within the great toe joint. A Chevron osteotomy is usually contraindicated when there is a significant amount of deviation of the toe or when the adductor muscles and ligaments are actually tight or there's an incongruity in the joint and also arthritis in the joint.
The end results of bunion surgery after the Chevron osteotomy are typically pretty good. In a study by Hans-Jorg Trnka and co-workers (reported in the JBJS in 2000) where they reviewed 57 people that went through a Chevron osteotomy with five yr follow up. These people documented that the range of motion of the big toe joint reduced between the initial assessment and the 2 year review but wasn't any worse at 5 years. They also described no alterations in the angle of the hallux valgus deviation between the 2 year and five year assessments. Those over the age of 50 years did as well as younger individuals that does put a question mark over the Chevron osteotomy largely being used for younger people. The Chevron osteotomy surgery might harm the arteries near the base of the big toe or hallux, however these investigators uncovered no cases of osteonecrosis in the first metatarsal bone at either the 2 year or five year follow-ups time frames. However, they did report that there was osteoarthritis of the great toe joint in eight feet at the 2 year follow-up and in 11 feet at five yr follow-up.
As with any surgical treatment for a bunion, the Chevron osteotomy is an effective alternative for the proper indications and when carried out by a surgeon who is experienced with those indications as well as limitations and has the technical abilities to accomplish the surgical treatment thoroughly. Just like any surgical procedures there are sometimes undesirable outcomes, although with the Chevron osteotomy the majority of them are generally managed. If you need bunion surgery, you will need to take it up with the doctor which method is best advised in your case along with what the outcomes are most likely to be.