What Is a Chevron Osteotomy?
A Chevron osteotomy is a common surgery to treat a bunion. A bunion (also
known as hallux valgus) is a malalignment of the knuckle of the big toe. This malalignment causes the big toe to turn toward the smaller toes. It often creates a bump at the base of the big toe. Bunions are not always painful, but this deformity generally
will get worse over time.
In a Chevron osteotomy, the foot and ankle orthopaedic surgeon cuts
the end of the long bone leading to the big toe (metatarsal) and shifts the end of the bone to straighten the big toe. This procedure may be performed in conjunction with soft tissue adjustments around the joint. This osteotomy is mostly performed
for mild to moderate bunion deformity. This bunion correction surgery relieves pain by straightening the big toe joint.
A dressing will be applied by your surgeon in the operating room, and you will be given a special shoe or boot. You may need to avoid putting weight on the foot or only put weight on the heel for a period of time determined by your surgeon. Dressings
are applied to help hold the big toe in position, so you should not change the dressings unless told to by your surgeon. Also, the dressings cannot get wet.
You will elevate your foot to chest level for the first few weeks after surgery. You may need to use crutches or a walker the first few days after this surgery. Limiting your activities will help to reduce pain and swelling and help prevent complications. Your surgeon may ask you to
do range-of-motion exercises (bending the knee, hip, or ankle) to maintain flexibility and to avoid stiffness.
Stitches usually are removed two weeks after surgery. In some cases, your surgeon may recommend physical therapy.
Prolonged swelling and difficulty fitting in shoes are very common following foot surgery and may last several months. Compression stockings and physical therapy can be helpful in reducing the swelling.
Risks and Complications
All surgeries come with possible complications, including the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots.
Potential complications with Chevron osteotomy include the bone failing to heal or disruption of the blood supply to the cut bone. Surgically corrected bunions have the potential for recurrence, even when the procedure was performed correctly. Patients
can help prevent this by following their doctor's post-operative instructions.
Is it better to have my bunion fixed now, or should I wait?
When the pain of a bunion interferes with daily activities or shoe modification options don’t help you, it's time to discuss surgical options with your foot and ankle orthopaedic surgeon. Together you can decide if surgery is best
for you. Bunions do get worse over time, and as the bunion worsens, the type of surgery you need may change.
How long will I have to be off of my foot after surgery?
In some cases, immediately after surgery, your surgeon may allow you to put as much weight on your foot as you feel comfortable doing. In other cases, your surgeon may not allow you to put weight on your foot for a period of time or will allow you to walk on your heel only.
What do I do if my bunion comes back?
No matter how well your surgery may have gone, there is always the chance that your bunion may come back. Often the new bunion is not painful and surgery is not needed. However, if your bunion comes back with pain, then you should talk
to your foot and ankle orthopaedic surgeon about revision surgery.
Original article by Ashish Shah, MD
Contributors/Reviewers: David Porter, MD; Elizabeth Cody, MD
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