Fixation Comparison for Chevron Osteotomies

Abstract

A comparison study of temporary K-wire fixation, permanent Herbert Whipple screw fixation, versus no osteotomy fixation was performed on distal chevron osteotomies for hallux valgus deformities. Nineteen chevron osteotomies were performed on 17 patients. Six patients received a Herbert Whipple screw for fixation, seven patients received temporary K-wire fixation, and six patients received no fixation for the chevron osteotomy. The average postoperative hallux valgus (HV) angle improved by 7.1° with no fixation, 6.3° with temporary K-wire fixation, and 9.5° with Herbert Whipple screw fixation. Comparison of the three groups using the Student's t-test revealed no statistical difference between the three groups (P = 0.6). The increased anesthesia time and operative costs for Herbert Whipple screw fixation was found to be statistically significant in comparison with the use of no fixation (P = <0.001). Time and cost studies were not significantly different for the K-wire and no fixation groups. Follow-up averaged 3.3 years. All patients reported satisfaction with the procedure and an improvement of their preoperative complaints. No significant difference in patient satisfaction was found to exist between the groups receiving fixation and those who did not have fixation. The results of this study can find no long-term benefit when comparing costs and patient satisfaction with the use of any temporary or permanent fixation of osteotomy sites when performing chevron osteotomies.