Distal Chevron Osteotomy without Fixation for Correction of Hallux Valgus: A Ten Year Retrospective Study
Bibliographic record
Abstract
Introduction: More than eighty surgical methods have been proposed to correct Hallux Valgus Deformity. This study evaluates the efficacy of Distal Chevron Osteotomy by means of assessing pre-operative and post-operative radiographic parameters and clinical results. Methods: The authors performed a ten-year retrospective study, on patients treated with Chevron Osteotomy alone without internal fixation, by the senior author, at the Toronto Western Hospital, between the years 2000-2009. The association of Hallux Valgus with demographics, other pre-operative foot pathology, etiology, intra-op pathology, complications (late and early) and radiographic parameters (pre-operative and post-operative IMA and HVA’s) were studied. Results: Two hundred and eight-five Chevron osteotomies were performed, on one hundred and seventy-eight patients with Hallux Valgus. In the study group 89% were female, the average age was 44 years ± 14 (range 16 to 77), 60% were bilateral. Radiographic measurements of the Hallux Valgus angle (HVA) and Intermetatarsal angle (IMA) demonstrated a statistically significant difference in pre-operative and post-operative measurements (p <0.05) t-test. The mean correction in the HVA for the left foot was 14.94 degrees compared with 14.98 degrees for the right foot. A mean correction of 1.99 degrees in the IMA for the left foot and 2.05 degrees for the right foot was obtained. The recurrence rate for Hallux Valgus was 0.70% (2 feet). In 12.36% of the study group, unexpected intra-operative findings such as EHL tendon contracture, bursae, intra-osseous ganglion cysts, and osteoporosis or capital osteophytes resulted in adding to, or modifying, the standard operative procedure. Conclusion: Despite minor and largely reversible post-operative complications, this study demonstrates that with distal Chevron osteotomy excellent radiographic and cosmetic correction of the deformity was achieved with a high level (99.30%) of patient satisfaction. Patients should be advised pre-operatively about their risk for developing Keloids 5.61%, transfer metatarsalgia 4.56% and recurrence 0.70% when treated by Chevron osteotomy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.020 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".