. .. Remerciements,

. .. Introduction,

. .. Materiel-et-methode,

.. .. La-série,

.. .. Données,

.. .. Résultats,

.. .. Résultats,

.. .. Analyse-statistique,

. .. La-technique-chirurgicale,

. .. Resultats,

.. .. Données,

.. .. Résultats,

.. .. Résultats,

.. .. Complications,

. .. Discussion,

. .. Conclusion,

. .. References,

. .. Annexes,

. .. Serment-d'hippocrate,

. .. Resume,

A. M. Perera, L. Mason, and M. M. Stephens, The pathogenesis of hallux valgus, J Bone Joint Surg Am. 7 sept, vol.93, issue.17, pp.1650-61, 2011.

Y. M. Golightly, M. T. Hannan, A. B. Dufour, H. J. Hillstrom, and J. M. Jordan, Foot disorders associated with overpronated and oversupinated foot function: the Johnston County osteoarthritis project, Foot Ankle Int, vol.35, issue.11, pp.1159-65, 2014.

S. Nix, M. Smith, and B. Vicenzino, Prevalence of hallux valgus in the general population: a systematic review and meta-analysis, J Foot Ankle Res. 27 sept, vol.3, p.21, 2010.

C. Lee, S. Lee, H. Kang, D. Jung, Y. Song et al., Genetic influences on hallux valgus in Koreans: the healthy twin study, Twin Res Hum Genet Off J Int Soc Twin Stud. avr, vol.17, issue.2, pp.121-127, 2014.

H. Okuda, S. Juman, A. Ueda, T. Miki, and M. Shima, Factors related to prevalence of hallux valgus in female university students: a cross-sectional study, J Epidemiol, vol.24, issue.3, pp.200-208, 2014.

M. T. Hannan, H. B. Menz, J. M. Jordan, L. A. Cupples, C. Cheng et al., High heritability of hallux valgus and lesser toe deformities in adult men and women, Arthritis Care Res. sept, vol.65, issue.9, pp.1515-1536, 2013.

C. Nery, M. J. Coughlin, D. Baumfeld, F. J. Ballerini, and S. Kobata, Hallux valgus in males--part 1: demographics, etiology, and comparative radiology, Foot Ankle Int. mai, vol.34, issue.5, pp.629-664, 2013.

C. Piqué-vidal, M. T. Solé, and J. Antich, Hallux valgus inheritance: pedigree research in 350 patients with bunion deformity, J Foot Ankle Surg Off Publ Am Coll Foot Ankle Surg. juin, vol.46, issue.3, pp.149-54, 2007.

H. B. Menz, E. Roddy, M. Marshall, M. J. Thomas, T. Rathod et al., Epidemiology of Shoe Wearing Patterns Over Time in Older Women: Associations With Foot Pain and Hallux Valgus, J Gerontol A Biol Sci Med Sci, vol.71, issue.12, pp.1682-1689, 2016.

J. Yu, J. Cheung, Y. Fan, Y. Zhang, A. Leung et al., Development of a finite element model of female foot for high-heeled shoe design, Clin Biomech Bristol Avon, vol.23, issue.1, pp.31-38, 2008.

B. Piclet-legré and W. Graff, Association française de chirurgie du pied. Hallux valgus, 2017.

M. J. Coughlin, C. L. Saltzman, and J. A. Nunley, Angular measurements in the evaluation of hallux valgus deformities: a report of the ad hoc committee of the American Orthopaedic Foot & Ankle Society on angular measurements, Foot Ankle Int. janv, vol.23, issue.1, pp.68-74, 2002.

A. Barker, AN OPERATION FOR HALLUX VALGUS. The Lancet. avr 1884, vol.123, p.655

G. , Symtomatische oder physiologische Behandlung des Hallux Valgus, Mund Med Xschr, issue.68, pp.1042-1047, 1921.

C. L. Mitchell, J. L. Fleming, R. Allen, C. Glenney, and G. A. Sanford, Osteotomy-bunionectomy for hallux valgus, J Bone Joint Surg Am. janv, vol.40, issue.1, pp.41-58, 1958.

D. W. Austin and E. O. Leventen, A new osteotomy for hallux valgus: a horizontally directed « V » displacement osteotomy of the metatarsal head for hallux valgus and primus varus, Clin Orthop. juin, issue.157, pp.25-30, 1981.

L. S. Weil, Scarf osteotomy for correction of hallux valgus. Historical perspective, surgical technique, and results, Foot Ankle Clin. sept, vol.5, issue.3, pp.559-80, 2000.

L. S. Barouk, Scarf osteotomy for hallux valgus correction. Local anatomy, surgical technique, and combination with other forefoot procedures, Foot Ankle Clin. sept, vol.5, issue.3, pp.525-58, 2000.

L. A. Mitchell and D. E. Baxter, A Chevron-Akin double osteotomy for correction of hallux valgus, Foot Ankle. août, vol.12, issue.1, pp.7-14, 1991.

M. E. Tollison and D. E. Baxter, Combination chevron plus Akin osteotomy for hallux valgus: should age be a limiting factor?, Foot Ankle Int. août, vol.18, issue.8, pp.477-81, 1997.

A. Basile, A. Battaglia, and A. Campi, Comparison of Chevron-Akin osteotomy and distal soft tissue reconstruction-Akin osteotomy for correction of mild hallux valgus, Foot Ankle Surg, vol.6, issue.3, pp.155-63, 2000.

Y. Arauz, J. M. , D. Vecchio, J. J. Codesido, M. Raimondi et al., Minimally invasive Akin osteotomy and lateral release: Anatomical structures at risk-A cadaveric study, Foot Edinb Scotl. juin, vol.27, pp.32-37, 2016.

K. Brogan, E. Lindisfarne, H. Akehurst, U. Farook, W. Shrier et al., Minimally Invasive and Open Distal Chevron Osteotomy for Mild to Moderate Hallux Valgus, Foot Ankle Int, vol.37, issue.11, pp.1197-204, 2016.

G. W. Choi, H. J. Kim, T. S. Kim, S. K. Chun, T. W. Kim et al., Comparison of the Modified McBride Procedure and the Distal Chevron Osteotomy for Mild to Moderate Hallux Valgus, J Foot Ankle Surg Off Publ Am Coll Foot Ankle Surg. août, vol.55, issue.4, pp.808-819, 2016.

B. Groningen, M. Van-der-steen, M. Reijman, J. Bos, and J. Hendriks, Outcomes in chevron osteotomy for Hallux Valgus in a large cohort, Foot Edinb Scotl. déc, vol.29, pp.18-24, 2016.

M. N. Baig, U. Baig, A. Tariq, and R. Din, A Prospective Study of Distal Metatarsal Chevron Osteotomies with K-Wire Fixations to Treat Hallux Valgus Deformities, Cureus. 20 sept, vol.9, issue.9, p.1704, 2017.

G. Kaufmann, D. Dammerer, F. Heyenbrock, M. Braito, L. Moertlbauer et al., Minimally invasive versus open chevron osteotomy for hallux valgus correction: a randomized controlled trial, Int Orthop. 4 juin, 2018.

C. Schulze, N. Böhme, C. Hacke, A. Gutcke, and P. Bergschmidt, Kramer and Chevron Osteotomy for Hallux Valgus Deformity -Retrospective Comparison of Functional and

. Z-orthopadie-unfallchirurgie, , 2018.

D. Giotis, N. K. Paschos, F. Zampeli, D. Giannoulis, A. Gantsos et al., Modified Chevron osteotomy for hallux valgus deformity in female athletes. A 2-year follow-up study, Foot Ankle Surg Off J Eur Soc Foot Ankle Surg. sept, vol.22, issue.3, pp.181-186, 2016.

D. Mahadevan, S. Lines, S. Hepple, I. Winson, and W. Harries, Extended plantar limb (modified) chevron osteotomy versus scarf osteotomy for hallux valgus correction: A randomised controlled trial, Foot Ankle Surg Off J Eur Soc Foot Ankle Surg. juin, vol.22, issue.2, pp.109-122, 2016.

T. Matsumoto, C. E. Gross, and S. G. Parekh, Short-Term Radiographic Outcome After Distal Chevron Osteotomy for Hallux Valgus Using Intramedullary Plates With an Amended Algorithm for the Surgical Management of Hallux Valgus, Foot Ankle Spec. 1 mars, 2018.

H. Kim, Y. Park, G. Kim, and Y. Park, Distal chevron osteotomy with lateral soft tissue release for moderate to severe hallux valgus decided using intraoperative varus stress radiographs, J Foot Ankle Surg Off Publ Am Coll Foot Ankle Surg. juin, vol.52, issue.3, pp.303-313, 2013.

M. Fakoor, N. Sarafan, P. Mohammadhoseini, M. Khorami, H. Arti et al., Comparison of Clinical Outcomes of Scarf and Chevron Osteotomies and the McBride Procedure in the Treatment of Hallux Valgus Deformity, Arch Bone Jt Surg. mars, vol.2, issue.1, pp.31-37, 2014.

W. Schneider, N. Aigner, O. Pinggera, and K. Knahr, Chevron osteotomy in hallux valgus. Ten-year results of 112 cases, J Bone Joint Surg Br. sept, vol.86, issue.7, pp.1016-1036, 2004.

R. M. Jeuken, M. Schotanus, N. P. Kort, A. Deenik, B. Jong et al., Long-term Follow-up of a Randomized Controlled Trial Comparing Scarf to Chevron Osteotomy in Hallux Valgus Correction, Foot Ankle Int. juill, vol.37, issue.7, pp.687-95, 2016.

Y. A. Radwan and A. Mansour, Percutaneous distal metatarsal osteotomy versus distal chevron osteotomy for correction of mild-to-moderate hallux valgus deformity, Arch Orthop Trauma Surg, vol.132, issue.11, pp.1539-1585, 2012.

X. Crevoisier, E. Mouhsine, V. Ortolano, B. Udin, and M. Dutoit, The scarf osteotomy for the treatment of hallux valgus deformity: a review of 84 cases, Foot Ankle Int. déc, vol.22, issue.12, pp.970-976, 2001.

J. Lucas-y-hernandez, P. Golanó, S. Roshan-zamir, V. Darcel, D. Chauveaux et al., Treatment of moderate hallux valgus by percutaneous, extra-articular reverse-L Chevron (PERC) osteotomy, Bone Jt J. mars, vol.98, issue.3, pp.365-73, 2016.

T. Bauer, D. Biau, A. Lortat-jacob, and P. Hardy, Percutaneous hallux valgus correction using the Reverdin-Isham osteotomy, Orthop Traumatol Surg Res OTSR. juin, vol.96, issue.4, pp.407-423, 2010.

R. A. Fuhrmann, H. Zollinger-kies, and H. Kundert, Mid-term results of Scarf osteotomy in hallux valgus, Int Orthop, vol.34, issue.7, pp.981-990, 2010.

M. J. Coughlin and B. W. Smith, Hallux valgus and first ray mobility. Surgical technique, J Bone Joint Surg Am. oct, vol.90, pp.153-70, 2008.

A. Robinson and J. P. Limbers, Modern concepts in the treatment of hallux valgus, J Bone Joint Surg Br. août, vol.87, issue.8, pp.1038-1083, 2005.

H. Park, K. Lee, C. Kim, and M. , Comparison of outcomes between proximal and distal chevron osteotomy, both with supplementary lateral soft-tissue release, for severe hallux valgus deformity: A prospective randomised controlled trial, Bone Jt J. avr, vol.95, issue.4, pp.510-516, 2013.

L. Collan, J. A. Kankare, and K. Mattila, The biomechanics of the first metatarsal bone in hallux valgus: a preliminary study utilizing a weight bearing extremity CT, Foot Ankle Surg Off J Eur Soc Foot Ankle Surg. sept, vol.19, issue.3, pp.155-61, 2013.

J. E. Swanson, M. G. Stoltman, C. R. Oyen, J. A. Mohrbacher, A. Orandi et al., Comparison of 2D-3D Measurements of Hallux and First Ray Sagittal Motion in Patients With and Without Hallux Valgus, Foot Ankle Int. févr, vol.37, issue.2, pp.227-259, 2016.

E. P. Cruz, F. V. Wagner, C. Henning, J. Sanhudo, F. Pagnussato et al., Comparison between Simple Radiographic and Computed Tomographic Three-Dimensional Reconstruction for Evaluation of the Distal Metatarsal Articular Angle, J Foot Ankle Surg Off Publ Am Coll Foot Ankle Surg. juin, vol.56, issue.3, pp.505-514, 2017.

T. Ota, T. Nagura, T. Kokubo, M. Kitashiro, N. Ogihara et al., Etiological factors in hallux valgus, a three-dimensional analysis of the first metatarsal, J Foot Ankle Res, vol.10, p.43, 2017.

D. B. Frumberg, Q. Naziri, R. Pivec, L. Bloom, B. Freeman et al., Rotational Deformity of the First Ray Precludes Accurate Distal Metatarsal Articular Angle Measurement in Hallux Valgus, J Long Term Eff Med Implants, vol.28, issue.1, pp.41-47, 2018.

B. Campbell, M. C. Miller, L. Williams, and S. F. Conti, Pilot Study of a 3-Dimensional Method for Analysis of Pronation of the First Metatarsal of Hallux Valgus Patients, Foot Ankle Int. 11 sept, p.1071100718793391, 2018.

A. R. Deenik, P. Pilot, S. E. Brandt, H. Van-mameren, R. Geesink et al., Scarf versus chevron osteotomy in hallux valgus: a randomized controlled trial in 96 patients, Foot Ankle Int. mai, vol.28, issue.5, pp.537-578, 2007.

E. Hirvensalo, O. Böstman, P. Törmälä, S. Vainionpää, and P. Rokkanen, Chevron osteotomy fixed with absorbable polyglycolide pins, Foot Ankle. févr, vol.11, issue.4, pp.212-220, 1991.

M. Torkki, S. Seitsalo, and P. Paavolainen, Chevron osteotomy for correction of hallux valgus: a long-term follow-up study, The Foot. juin, vol.11, issue.2, pp.91-94, 2001.

S. M. Raikin, A. G. Miller, and J. Daniel, Recurrence of hallux valgus: a review, Foot Ankle Clin. juin, vol.19, issue.2, pp.259-74, 2014.

R. Okuda, M. Kinoshita, T. Yasuda, T. Jotoku, H. Shima et al., Hallux valgus angle as a predictor of recurrence following proximal metatarsal osteotomy, J Orthop Sci Off J Jpn Orthop Assoc, vol.16, issue.6, pp.760-764, 2011.

S. Velkes, A. Ganel, B. Nagris, and F. Lokiec, Chevron osteotomy in the treatment of hallux valgus, J Foot Surg. juin, vol.30, issue.3, pp.276-284, 1991.

R. M. Murphy, L. M. Fallat, and J. P. Kish, Axial loading screw fixation for chevron type osteotomies of the distal first metatarsal: a retrospective outcomes analysis, J Foot Ankle Surg Off Publ Am Coll Foot Ankle Surg. févr, vol.53, issue.1, pp.52-56, 2014.

E. Maceira and M. Monteagudo, Transfer metatarsalgia post hallux valgus surgery, Foot Ankle Clin. juin, vol.19, issue.2, pp.285-307, 2014.

K. David-west, Complications associated with Mitchell's Osteotomy for Hallux Valgus Correction: A retrospective hospital review. Foot Ankle Online J [Internet]. 1 mars, 2011.

D. Sur,

C. H. Kuo, P. J. Huang, Y. M. Cheng, K. Y. Huang, T. B. Chen et al., Modified Mitchell osteotomy for hallux valgus, Foot Ankle Int. sept, vol.19, issue.9, pp.585-594, 1998.

M. Rothwell and J. Pickard, The chevron osteotomy and avascular necrosis, Foot Edinb Scotl. mars, vol.23, issue.1, pp.34-42, 2013.

K. J. Choi, H. S. Lee, Y. S. Yoon, S. S. Park, J. S. Kim et al., Distal metatarsal osteotomy for hallux varus following surgery for hallux valgus, J Bone Joint Surg Br. août, vol.93, issue.8, pp.1079-83, 2011.

, Angles mesurés dans l'étude : M1-P1 = HVA (Hallux Valgus Angle) et M1-M2 = IMA (Inter Metatarsal Angle, vol.2, p.78, 1996.

, Mon premier souci sera de rétablir, de préserver ou de promouvoir la santé dans tous ses éléments, physiques et mentaux

, Je respecterai toutes les personnes, leur autonomie et leur volonté, sans aucune discrimination selon leur état ou leurs convictions. J'interviendrai pour les protéger si elles sont affaiblies, vulnérables ou menacées dans leur intégrité ou leur dignité. Même sous la contrainte

, L'analyse était clinique (AOFAS, douleur, mobilités articulaires, complications, récidive, satisfaction) et radiographique (Inter Métatarsal Angle IMA, Hallux Valgus Angle HVA

, Le score AOFAS pré opératoire 66,35 +/-7,4 [47-85] a été amélioré à 1an de 28,63 points (p<0,001) avec un résultat stable au dernier recul. L'AOFAS douleur était en pré opératoire de 26,8 +/-6, de 38 +/-4 à 1an et 39 +/-3,4 au dernier recul (p<0,001), 95% femmes) ont été opérés d'un hallux valgus et ont eu un suivi minimal d'un an post opératoire, et 60 patients (74pieds) ont été revus au dernier recul

L. , hallux valgus par mini Chevron est une technique simple, reproductible, efficace avec une amélioration significative de la qualité de vie des patients, fiable dans le temps, qui apporte une satisfaction importante, avec taux de complications acceptable. Il s'agit donc d'un véritable outil