A chevron osteotomy is a surgical procedure for correcting bunions, common foot deformities. It involves a precise, V-shaped cut in a foot bone for realignment. Its goal is to address underlying structural issues, improving foot mechanics and reducing discomfort.
Understanding Chevron Osteotomy
A bunion (hallux valgus) is a bony lump on the side of the foot at the base of the big toe. It occurs when the big toe leans inward, pushing towards other toes, causing the joint to protrude. This misalignment can cause pain, swelling, and difficulty wearing shoes. The condition often worsens over time, affecting foot appearance and function.
The term “chevron” refers to the V-shape of the bone cut. This cut is made in the head of the first metatarsal bone, which connects the big toe to the midfoot. It is chosen for mild to moderate bunion deformities, allowing a controlled shift of the bone segment to improve big toe alignment.
The Surgical Process
A chevron osteotomy is an outpatient procedure, with patients often returning home within hours. Anesthesia varies, often a regional nerve block to numb the foot, sometimes with sedation or general anesthesia.
A small incision is made on the side or inside of the foot, over the big toe joint, to access bone and soft tissues. Once exposed, a V-shaped cut is made in the first metatarsal bone near its head. The V-cut’s apex is at the metatarsal head’s center, allowing controlled bone separation. This enables the surgeon to shift the metatarsal head laterally, away from the second toe, realigning the big toe. Sometimes, soft tissue adjustments around the joint are also performed to enhance correction.
After repositioning, the bone segment is secured in its new alignment with small implants. Fixation is commonly achieved with screws or pins, such as Kirschner wires, holding bone fragments together while they heal. Type and number of fixation devices depend on the individual case and surgeon’s preference. The incision is then closed with sutures or staples.
Post-Surgical Recovery
Immediately after a chevron osteotomy, the foot is wrapped in a dressing and placed in a surgical shoe or boot to protect the site and maintain alignment. Elevating the foot and applying ice minimize swelling and reduce pain. Patients receive pain medication, including prescribed drugs and over-the-counter options like ibuprofen or acetaminophen. Initial weight-bearing restrictions are common; some surgeons allow immediate weight-bearing on the heel in a protective shoe, while others advise limited or non-weight-bearing for weeks.
Keep the surgical dressing dry and intact until the first follow-up appointment, usually around two weeks post-surgery. At this visit, the dressing is changed, and sutures may be removed. Activity levels increase gradually as healing progresses, with restrictions on strenuous activities to prevent complications.
Gentle range-of-motion exercises for the foot and ankle may be initiated as part of early rehabilitation. While significant pain subsides within weeks, some swelling can persist for months due to healing. Physical therapy may be recommended to restore strength and flexibility.