Research Article
Comparison of Bioabsorbable Magnesium versus Titanium
Screw Fixation for Modified Distal Chevron Osteotomy in
Hallux Valgus
Baver Acar , Ozkan Kose , Adil Turan, Melih Unal, Yusuf Alper Kati, and Ferhat Guler
University of Health Sciences, Antalya Training and Research Hospital, Department of Orthopedics and Traumatology, Antalya, Turkey
Correspondence should be addressed to Baver Acar; baveracar@hotmail.com
Received 5 July 2018; Accepted 6 November 2018; Published 19 November 2018
Academic Editor: Milena Fini
Copyright © 2018 Baver Acar et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective. Te purpose of this retrospective study was to compare the clinical and radiological results of magnesium versus titanium
screw fxation for modifed distal chevron osteotomy in hallux valgus (HV). Materials and Methods. A total of 31 patients who
underwent modifed distal chevron osteotomy for HV deformity between 2014 and 2017 were reviewed retrospectively. Headless
magnesium (Mg) compression screw fxation was applied in 16 patients (17 feet) and headless titanium (Ti) compression screw
in 15 patients (17 feet). Patients were followed up for at least 12 months with a mean of 19.0 ± 6.8 months in the Mg screw group
and 16.2 ± 6.19 in the Ti screw group, respectively (p: 0.234). Clinical results were evaluated using the American Orthopedic Foot
and Ankle Society Hallux metatarsophalangeal-interphalangeal (AOFAS-MTP-IP) scale and a visual analogue scale (VAS). Te
hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured before and afer surgery. Time to osteotomy union
and any complications were recorded and compared between the groups. Results. An improvement in the AOFAS-MTP-IP scale
and VAS points were recorded in both groups with no statistically signifcant diference between the groups (p: 0.764 and 0.535,
resp.). At the fnal follow-up examination, HVA and IMA were similar (p: 0.226 and 0.712, resp.). Tere was no signifcant loss of
correction between the early and fnal radiographs in respect of HVA and IMA in both groups (p: 0.321 and p: 0.067). Full union
of the osteotomy was obtained in all patients. Prolonged (1.5 months) swelling and mild hyperemia around the surgical incision
were observed in 1 patient in the Mg group but there was a good response to physical and medical therapy, and the complaints were
completely resolved. Tere were no other signifcant complications in either group. Conclusion. Te results of this study showed
that bioabsorbable Mg compression screw fxation has similar therapeutic efcacy to Ti screw fxation in respect of functional and
radiological outcomes. Bioabsorbable Mg screw is an alternative fxation material that can be safely used for modifed distal chevron
osteotomy in HV surgery.
1. Introduction
Hallux valgus (HV) is a common foot deformity that may
cause pain, disability, difculty in shoe wear, and gait dis-
turbance. Initially, a period of conservative care can be tried
but if the symptoms are not relieved and the deformity
has progressed, surgical correction is usually necessitated.
More than 300 surgical procedures have been described
over the years for the correction of HV deformity [1]. Te
decision-making process for HV surgery depends on the
severity of the deformity determined by the clinical fndings
and radiological measurements. Currently, distal metatarsal
chevron osteotomy is commonly used for the correction of
mild-to-moderate HV deformities with a congruent metatar-
sophalangeal (MTP) joint [2].
Te technique for a distal chevron osteotomy was initially
described by Austin and Leventen without performing an
osseous fxation [3]. Tese authors thought that the three-
dimensional confguration of the osteotomy was inherently
stable and additional medial capsulorrhaphy provided fur-
ther stability. Subsequently several modifcations have been
made to the technical part of the procedure, including the
angle of the osteotomy and the use of various alternative
methods of internal fxation [4]. Te reason behind these
Hindawi
BioMed Research International
Volume 2018, Article ID 5242806, 9 pages
https://doi.org/10.1155/2018/5242806