The biplanar and triplanar chevron osteotomies equally effective in moderate hallux valgus: study

Hallux valgus is a common disorder of the foot. The chevron osteotomy is among the most common methods of surgically correcting mild to moderate hallux valgus, though it has been associated with inadequate distal metatarsal articular angle (DMAA) correction and a risk of hallux valgus recurrence.

Feeney et al conducted a study to compare the effectiveness of the triplanar and biplanar chevron osteotomies in correcting mild to moderate hallux valgus and specifically to determine if the triplanar chevron osteotomy results in superior correction of the DMAA compared to the biplanar chevron osteotomy.

A retrospective review of patient medical charts and preoperative and postoperative radiographs was performed. A total of 55 patients were included, with 28 patients in the biplanar chevron group and 27 patients in the triplanar chevron group. The DMAA and intermetatarsal (IM) angles were measured on preoperative and postoperative radiographs. Statistical analysis was carried out on SPSS.

The key findings of the study were:

• The DMAA and IM angles improved significantly in both groups (p = <0.001).

• There was no significant difference in the mean postoperative IM angle in the biplanar versus triplanar groups (9.58 degrees versus 9.19 degrees, respectively, p = 0.279).

• There was a significant difference in the mean postoperative DMMA in the triplanar versus biplanar groups (7.88 degrees versus 8.79 degrees, respectively, p = 0.026).

The authors concluded – “This study analyzed the radiological outcomes following the correction of hallux valgus with either a biplanar or triplanar chevron osteotomy. The results from this study suggest that both the biplanar chevron osteotomy and triplanar chevron osteotomy are equally effective in reducing the IM angle in mild to moderate hallux valgus. In addition, both the biplanar chevron osteotomy and the triplanar chevron osteotomy result in a significant reduction in DMAA. However, our study suggests that the addition of a medial closing wedge osteotomy in the triplanar chevron osteotomy has the potential to increase the correction of the DMAA, particularly in the case of a larger preoperative DMAA, when compared with the biplanar chevron osteotomy. The authors recommend the addition of a medial closing wedge osteotomy to the standard chevron osteotomy in the case of a large DMAA. It is possible that this may reduce the risk of hallux valgus recurrence in the follow-up period. However, further studies with long-term radiographic follow-up are required to determine if superior DMAA correction decreases the likelihood of hallux valgus recurrence postoperatively.”

For further details on the article refer to:

Feeney K M, D'Souza L (April 26, 2026) Biplanar Versus Triplanar Chevron Osteotomy for the Correction of Hallux Valgus: A Comparison of Radiologic Outcomes. Cureus 18(4): e107753. DOI 10.7759/cureus.107753