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Peer-reviewedCC BY-NC-NDJournal of orthopaedic surgery and research

A comparative study of distal chevron osteotomy and minimally invasive surgery for surgical correction of hallux valgus deformity.

5 affiliations
  1. 1The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
  2. 2Nanobiomedical Science, Dankook University, Cheonan, Republic of Korea.
  3. 3Department of Orthopedic Surgery, Hanyang University College of Medicine, Seoul, Republic of Korea.
  4. 4Department of Orthopedic Surgery, Hanyang University College of Medicine, Seoul, Republic of Korea. [email protected].
  5. 5Department of Orthopedic Surgery, Hanyang University Guri hospital, Seoul, Republic of Korea. [email protected].

Abstract

Background

Hallux valgus is a common forefoot deformity that significantly impacts patients' functional status and quality of life. This study aims to compare the mid-term clinical and radiographic outcomes of DCMO and MIS in hallux valgus correction.Methods

A retrospective cohort study for 60 patients (34 DCMO, 26 MIS) was analyzed. Clinical outcomes were evaluated using the Manchester-Oxford Foot Questionnaire (MOXFQ) and Foot Function Index (FFI), while radiographic parameters such as hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), and sesamoid position were assessed preoperatively and at the final follow-up. Statistical comparisons were performed using t-tests, Mann-Whitney U tests, and chi-square tests, with significance set at p < 0.05.Results

The DCMO group demonstrated superior clinical outcomes, with significantly better MOXFQ pain sub-scale (p < 0.001) and index scores (p = 0.002). However, although the between-group difference in pain-related outcomes was statistically significant, it did not reach the minimal clinically important difference (MCID), indicating that the clinical relevance of this advantage may be limited. The improvement in FFI scores was also significantly greater in the DCMO group (p = 0.022). In contrast, the MIS group exhibited superior radiographic correction, with significantly greater improvements in HVA (p = 0.027), IMA (p = 0.001), and sesamoid displacement (p = 0.001). First metatarsal shortening was more pronounced in the MIS group, showing a trend towards statistical significance (p = 0.050). Postoperative complications were comparable, with recurrence rates of 8.8% (DCMO) and 7.6% (MIS).Conclusions

DCMO showed statistically superior patient-reported outcomes, although its pain-related benefit did not exceed the MCID. MIS achieved greater radiographic correction. Procedure selection should be individualized according to patient-specific factors, radiographic goals, and surgeon expertise. In addition, surgeons transitioning to MIS should be aware of the potential risk of frictional heat-related soft tissue injury and should use meticulous fluoroscopic guidance, controlled instrumentation, and adequate irrigation to minimize this complication.

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BibTeX
@article{hwang2026comparative,
  title = {{A comparative study of distal chevron osteotomy and minimally invasive surgery for surgical correction of hallux valgus deformity.}},
  author = {Jihyun Hwang and Sukjin Shin and Seung Hun Baek and Sung Jae Kim},
  journal = {Journal of orthopaedic surgery and research},
  year = {2026},
  month = jul,
  doi = {10.1186/s13018-026-07098-3},
  url = {https://europepmc.org/article/MED/42894245},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - A comparative study of distal chevron osteotomy and minimally invasive surgery for surgical correction of hallux valgus deformity.
AU  - Jihyun Hwang
AU  - Sukjin Shin
AU  - Seung Hun Baek
AU  - Sung Jae Kim
PY  - 2026
DA  - 2026/07/01
JO  - Journal of orthopaedic surgery and research
DO  - 10.1186/s13018-026-07098-3
UR  - https://europepmc.org/article/MED/42894245
AB  - Background  Hallux valgus is a common forefoot deformity that significantly impacts patients' functional status and quality of life. This study aims to compare the mid-term clinical and radiographic outcomes of DCMO and MIS in hallux valgus correction.Methods  A retrospective cohort study for 60 patients (34 DCMO, 26 MIS) was analyzed. Clinical outcomes were evaluated using the Manchester-Oxford Foot Questionnaire (MOXFQ) and Foot Function Index (FFI), while radiographic parameters such as hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), and sesamoid position were assessed preoperatively and at the final follow-up. Statistical comparisons were performed using t-tests, Mann-Whitney U tests, and chi-square tests, with significance set at p < 0.05.Results  The DCMO group demonstrated superior clinical outcomes, with significantly better MOXFQ pain sub-scale (p < 0.001) and index scores (p = 0.002). However, although the between-group difference in pain-related outcomes was statistically significant, it did not reach the minimal clinically important difference (MCID), indicating that the clinical relevance of this advantage may be limited. The improvement in FFI scores was also significantly greater in the DCMO group (p = 0.022). In contrast, the MIS group exhibited superior radiographic correction, with significantly greater improvements in HVA (p = 0.027), IMA (p = 0.001), and sesamoid displacement (p = 0.001). First metatarsal shortening was more pronounced in the MIS group, showing a trend towards statistical significance (p = 0.050). Postoperative complications were comparable, with recurrence rates of 8.8% (DCMO) and 7.6% (MIS).Conclusions  DCMO showed statistically superior patient-reported outcomes, although its pain-related benefit did not exceed the MCID. MIS achieved greater radiographic correction. Procedure selection should be individualized according to patient-specific factors, radiographic goals, and surgeon expertise. In addition, surgeons transitioning to MIS should be aware of the potential risk of frictional heat-related soft tissue injury and should use meticulous fluoroscopic guidance, controlled instrumentation, and adequate irrigation to minimize this complication.
SN  - 1749-799X
ER  -