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TheScientificWorldJOURNAL
Volume 11, Pages 657-661
http://dx.doi.org/10.1100/tsw.2011.66
Case Study

Revisional Surgery for Hallux Valgus with Serial Osteotomies at Two Levels

1University of Glasgow (Medical Student), Glasgow, UK
2Consultant Orthopaedic Surgeon, Orthopaedic Department, Royal Hospital for Sick Children (Yorkhill), Glasgow, UK

Received 19 January 2011; Revised 22 February 2011; Accepted 24 February 2011

Academic Editor: Graham V. Lees

Copyright © 2011 Jason B. T. Lim and James S. Huntley.

Abstract

The aetiology and form of hallux valgus (HV) is varied with many corrective procedures described. We report a 39-year-old woman, previously treated with a Chevron osteotomy, who presented with recurrent right HV, metatarsus primus varus, and associated bunion. Osteotomies were performed at two levels as a revisional procedure. This report highlights (1) limitations of the Chevron osteotomy and (2) the revisional procedure of the two level osteotomies: (i) proximal opening-wedge basal osteotomy and (ii) distal short Scarf with medial closing wedges. If a Chevron osteotomy is used inappropriately, for example, in an attempt to correct too large a deformity, it may angulate laterally causing a malunion with an increased distal metatarsal articular angle. Secondly, it is feasible to correct this combined deformity using a combination of proximal opening-wedge and distal short Scarf osteotomies.