Superiority of ultra-shortterm clinical outcome after minimally invasive distal metatarsal chevron osteotomy in comparison to the open technique: a prospective study.

Abstract

Swelling and pain is a frequent finding after hallux valgus correction. Aim of our study was to detect clinical differences in the initial postoperative period after minimally invasive chevron osteotomy (MIS) and the open chevron technique (OC). From the included patients clinical outcome was assessed preoperatively, and then at two, four, six and 12 weeks postopertively in terms of the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot Score, the Japanese Society for Surgery of the Foot (JSSF) metatarsophalangeal-interphalangeal Scale, the Maryland Foot Score (MFS), the SF12 Life Quality Scale, the Visual Analogue Scores (VAS) of pain, swelling of the foot, range of motion (ROM) and patient satisfaction. Radiographic parameters were taken preoperatively, as well as two, six and twelve weeks after surgery. The Charlson Comorbidity Index (CCI) was recorded preoperatively only, pain medication consumption was documented for the intial two weeks after surgery. Sixty-three feet were analyzed (33 MIS; 30 OC). Patient demographic characteristics and amount of the deformity in both groups did not differ significantly. Both techniques demonstrated good radiographic correction of the hallux deformity without superiority of one technique. We detected lower pain levels and reduced pain medication consumption as well as reduced swelling in the MIS group at the time points two, four and six weeks postoperatively. AOFAS score and the satisfaction score showed significantly better results in the MIS group as well. Minimally invasive chevron osteotomy shows better clinical ultra-shortterm outcome and lower pain levels in comparision to the open technique with comparable radiographic results.