Distal Chevron Osteotomy for Correction of Hallux Valgus Deformity

Distal chevron osteotomy has been used successfully for correction of mild to moderate hallux valgus deformity as an alternative to modified McBride bunionectomy for many years. Patients who have experienced a successful outcome typically have less than 35° of hallux valgus deformity and intermetatarsal angles of less than 15°. Pitfalls of distal chevron osteotomy include shortening of the first metatarsal shaft, nonunion and malunion of the osteotomy, transfer metatarsalgia, avascular necrosis of the first metatarsal head, and subsequent joint stiffness. The distal chevron osteotomy can be augmented with a release of the lateral joint capsule and adductor hallucis tendon through the medial joint space. This release often provides better sesamoid correction and has not been associated with avascular necrosis if performed properly.