The risk of avascular necrosis following chevron osteotomy : A prospective study using bone scintigraphy

Published online: Apr 27 2009

Raheel Shariff, Fahad Attar, Donald Osarumwene, Rehan Siddique, Gulam Dastagir Attar

From the Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom


Controversy exists with regard to the effects of chevron osteotomy on blood supply and subsequent development of avascular necrosis (AVN) of the first metatarsal head. The aim of this study was to assess the incidence of avascular necrosis in our centre following chevron osteotomy for hallux valgus, using bone scintigraphy. Thirty nine patients who had a chevron osteotomy for treatment of hallux valgus were prospectively studied. Mean follow-up was 14 months. Bone scinti graphy was used to assess metatarsal head perfusion at an average 8.5 weeks post operatively. Three patients (7.7%) showed abnormal bone scan around the metatarsal head. Further evaluation of these patients did not show any sign of AVN. We conclude there appears to be a risk of circulatory disturbance to the metatarsal head following chevron osteotomy of the first metarsal (7.7% in this study) ; however this does not translate into clinically significant AVN.