The use of 3D-Printed cutting guide improves the accuracy of distal chevron osteotomy for hallux valgus surgery.

Abstract

BackgroundDistal chevron osteotomy is a common procedure for hallux valgus. Alteration of the osteotomy axis and angle can result in excessive change in length of the first metatarsal and hence the increased risk of transfer metatarsalgia. However, many of the Chevron osteotomies were performed freehand without objective guidance.MethodTwo surgeons with different experience levels (Resident trainee, consultant) using two techniques (freehand or with cutting guide) to perform 15 distal chevron osteotomies on 3D-printed identical first metatarsal sawbone models. The medial cutting angle and lateral exit angle and their difference were analysed. The time taken for each osteotomy was also recorded.ResultsThe use of cutting guide brought the medial angle significantly closer to the desired angle of 60° (as described by Austin) for both surgeons, regardless of experience. The lateral angle was significantly closer to 60° in the consultant subgroup.ConclusionThe study demonstrated that the cutting guide improves accuracy in the osteotomy angle of distal Chevron osteotomy in hallux valgus surgery, regardless of level of experience of the surgeon. Precise osteotomy angles are critical for optimising hallux valgus deformity correction in clinical practice. The cutting guide reduces inter-surgeon variability, enabling less experienced surgeons to achieve reliable results. By standardising the technique, it enhances procedural consistency. While these findings suggest improved reliability for hallux valgus correction, further clinical studies are required to evaluate the direct impact on patient outcomes.