Clemente P, Mariscal G, Barrios C: Distal chevron osteotomy versus different operative procedures for hallux valgus correction: a meta-analysis. J Orthop Surg Res 17: 80, 2022.
Pietrzykowska E, Romelczyk-Baishya B, Chodara A, et al: Microstructure and mechanical properties of inverse nanocomposite made from polylactide and hydroxyapatite nanoparticles. Materials (Basel) 15: 184, 2021.
Ibrahim AM, Koolen PG, Kim K, et al: Absorbable biologically based internal fixation. Clin Podiatr Med Surg 32: 61, 2015.
Daghino W, Bistolfi A, Aprato A, et al: Bioabsorbable implants in foot trauma surgery. Injury 50 (suppl 4): S47, 2019.
Liu C, Huang L, Zhang H, et al: Biomechanical comparison between bioabsorbable and medical titanium screws in distal chevron osteotomy of first metatarsal in hallux valgus treatment. J Mech Behav Biomed Mater 131: 105260, 2022.
Small HN, Braly WG, Tullos HS: Fixation of the chevron osteotomy utilizing absorbable polydioxanon pins. Foot Ankle Int 16: 346, 1995.
Song JH, Kang C, Park WH, et al: Extended distal chevron osteotomy and Akin osteotomy using bioabsorbable materials for treatment of moderate to severe hallux valgus. J Foot Ankle Surg 60: 1110, 2021.
Morandi A, Ungaro E, Fraccia A, et al: Chevron osteotomy of the first metatarsal stabilized with an absorbable pin: our 5-year experience. Foot Ankle Int 34: 380, 2013.
Caminear DS, Pavlovich R, Pietrzak WS: Fixation of the chevron osteotomy with an absorbable copolymer pin for treatment of hallux valgus deformity. J Foot Ankle Surg 44: 203, 2005.
Giotis D, Paschos NK, Zampeli F, et al: Modified chevron osteotomy for hallux valgus deformity in female athletes. A 2-year follow-up study. Foot Ankle Surg 22: 181, 2016.
Komur B, Yilmaz B, Kaan E, et al: Mid-term results of two different fixation methods for chevron osteotomy for correction of hallux valgus. J Foot Ankle Surg 57: 904, 2018.
Zhang S, Wang X, Chen T, et al: Outcomes of modified chevron osteotomy for hallux valgus. Foot Ankle Surg 28: 514, 2022.
Favre P, Farine M, Snedeker J, et al: Biomechanical consequences of first metatarsal osteotomy in treating hallux valgus. Clin Biomech (Bristol) 25: 721, 2010.
Hong Z, Zhang P, He C, et al: Nano-composite of poly(L-lactide) and surface grafted hydroxyapatite: mechanical properties and biocompatibility. Biomaterials 26: 6296, 2005.
Perren SM: Fracture healing: fracture healing understood as the result of a fascinating cascade of physical and biological interactions. Part I. An attempt to integrate observations from 30 years AO research. Acta Chir Orthop Traumatol Cech 81: 355, 2014.
Perren SM, Fernandez A, Regazzoni P: Understanding fracture healing biomechanics based on the “strain” concept and its clinical applications. Acta Chir Orthop Traumatol Cech 82: 253, 2015.
Foster AL, Moriarty TF, Zalavras C, et al: The influence of biomechanical stability on bone healing and fracture-related infection: the legacy of Stephan Perren. Injury 52: 43, 2021.
Trnka HJ: Managing complications of foot and ankle surgery: hallux valgus. Foot Ankle Clin 27: 271, 2022.
Bostman OM, Pihlajamaki HK: Adverse tissue reactions to bioabsorbable fixation devices. Clin Orthop Relat Res (371): 216, 2000.
Pavlovich R, Caminear D: Granuloma formation after chevron osteotomy fixation with absorbable copolymer pin: a case report. J Foot Ankle Surg 42: 226, 2003.
Cui Y, Liu Y, Cui Y, et al: The nanocomposite scaffold of poly(lactide-co-glycolide) and hydroxyapatite surface-grafted with L-lactic acid oligomer for bone repair. Acta Biomater 5: 2680, 2009.
Bello-Tejeda L, Perez-Aznar A, Sebastia-Forcada E, et al: Sesamoid position change over 2 years after distal chevron osteotomy for moderate to severe hallux valgus: a prospective cohort study. Foot Ankle Int 44: 95, 2023.
Chen JY, Rikhraj K, Gatot C, et al: Tibial sesamoid position influence on functional outcome and satisfaction after hallux valgus surgery. Foot Ankle Int 37: 1178, 2016.
Kim TH, Choi YR, Lee HS, et al: Relationship between hallux valgus recurrence and sesamoid position on anteroposterior standing radiographs after distal chevron metatarsal osteotomy. Foot Ankle Int 44: 130, 2023.
Zitouna K, Selmene MA, Khlif MA, et al: Effect of sesamoid position on functional outcome of operated hallux valgus. Tunis Med 97: 1370, 2019.
Background: This study aimed to investigate the safety and reliability of using bioabsorbable screws for the fixation of chevron osteotomy in the treatment of hallux valgus (HV) deformity.
Methods: Clinical cases of chevron osteotomy in the treatment of HV deformities in our hospital between December 2018 and August 2022 were retrospectively summarized to compare preoperative imaging indices, including HV angle (HVA), intermetatarsal angle, and tibial sesamoid position, with those at the final follow-up session. The American Orthopaedic Foot & Ankle Society hallux metatarsophalangeal-interphalangeal scale, 36-Item Short Form Survey, and European Foot and Ankle Society scale were used to assess therapeutic efficacy. The visual analog scale was used to assess pain relief. Moreover, complications were recorded.
Results: Twenty-six patients (39 feet) were included, and the mean follow-up period was 24.0 months. No infection, delayed healing, or nonhealing was recorded. The osteotomy ends healed well without nonunion or delayed union. Four cases of recurrence (HVA ≥20°), two cases of numbness in the distal toe, one case of necrosis of the first metatarsal head, and one case of osteoarthritis of the first metatarsophalangeal joint occurred. No patients underwent secondary surgery. The HVA, intermetatarsal angle, and tibial sesamoid position significantly reduced at the final follow-up session compared with their preoperative values, and significant improvement was seen in clinical scores.
Conclusions: The use of bioabsorbable screws for the fixation of chevron osteotomy is safe and effective in the treatment of HV deformities.