Chevron Osteotomy for the Treatment of Hallux Valgus

Seventy-six chevron osteotomies with follow-up periods ranging from six months to eight years were reviewed. The majority of patients had pain over the bunion prior to operation, and 27 also presented with second metatarsalgia. After surgery there was a marked decrease of pain in the first metatarso-phalangeal joint, and in 18 feet the second metatarsalgia was either eliminated or markedly decreased. Most patients were pleased with the appearance of the feet after surgery, but almost one-third of the women complained of difficulty in wearing high heels. The surgical technique is straightforward, but careful attention to detail is necessary to obtain a consistent and satisfactory result. The Boston thoracic brace, i.e., a Boston brace with axillary support, was used to treat thoracic scoliosis in 44 patients. The mean initial correction for curves with the apex at T8-T9 was 15.9° ± 6.1° (54%). This was a great and significant improvement over results obtained with both the Boston brace and the Boston Milwaukee brace. This degree of correction confirms earlier observations that the increased efficiency of the brace outweighs the disadvantages of the axillary component and encourages further efforts in the direction of nonsurgical treatment of the early stages of scoliosis.