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What is the Chevron Osteotomy?

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.

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How useful are bunion correctors?

Bunions really are a very common condition of the feet. These are primarily caused by the shoes that happen to be too tight pushing the big toe over and causing the joint at the base of the big toe to become enlarged. That's what a bunion is. The continued force from the footwear may become rather painful and osteoarthritis can develop within the joint. Bunions are more prevalent in females, quite possibly since they are very likely to wear more firmly fitting high heel shoes. The only method to make them go away will be to have surgery. Because we walk on the feet and that big toe or hallux is an important joint, surgery on that joint is connected with a time period of at least a few months of impairment after the surgery. On that basis, many people want to avoid the surgical option when they can.

There really are no non-surgical choices to make them go away. However, there are many different conservative alternatives that may stop them being painful, but they are not able to get rid of them. You will find the Bunion correctors which are splints that you put on during the night which are expected to fix the angle of the big toe. These Bunion correctors do keep your toe mobile and flexible which is a good thing, but they don't make anymore than a few degrees change to the angle of the toe. Exercises to maintain the metatarsophalangeal joint mobile and flexible are often helpful with some of the pain which could occur within the joint. If there is pain on the metatarsophalangeal joint from force from the shoe, then it is essential that the footwear be wide enough and fitted appropriately. Various pads could be used to keep pressure off the enlarged metatarsophalangeal joint. These non-surgical choices will never make them disappear, but they will go along way to helping any discomfort that they can have from the bunions.