Scarf versus long chevron osteotomies for the treatment of hallux valgus: A prospective randomized controlled study. Issue 4 (August 2019)

• Record Type: Journal Article
• Authors: Elshazly, Ossama; Abdel Rahman, Amr Farouk; Fahmy, Hesham; Sobhy, Mohamed H.; Abdelhadi, Wael
• Is Part Of: Foot and ankle surgery. Volume 25:Issue 4(2019)
• Page Start: 469
• Page End: 477
• Publication Date: 2019-08
• Subjects: Hallux valgus -- Scarf osteotomy -- Chevron osteotomy -- Comparative metatarsal osteotomies -- Forefoot deformity -- Forefoot surgery; Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; Ankle -- surgery -- Periodicals; Foot -- surgery -- Periodicals; Ankle -- Surgery; Foot -- Surgery; Periodicals; Electronic journals; 617.58
• DOI: 10.1016/j.fas.2018.02.017
• Languages: English
• ISSNs: 1268-7731

Abstract

Highlights: No single osteotomy can address all cases of hallux valgus and treatment should address each patient according to his needs and peculiarities. This is a prospective RCT to compare scarf osteotomy (of good corrective power but technically demanding) to extended chevron (long plantar limb with simpler technique) regarding power of deformity correction, radiological results, patient scoring system and complication rate. Group A (scarf) 21 patients was compared to group B (long chevron) with 22 patients, shorter operative time was in favour of long chevron group. Radiological correction was similar in both groups. Improvement of functional score was more in the long chevron group. Complication rate was similar in both osteotomies. Abstract: Background: The aim of this study is to compare scarf osteotomy and long chevron osteotomy in treatment of hallux valgus deformity regarding operative time, power of correction and complications. Design: A prospective randomized controlled comparative trial. Methods: 48 cases with hallux valgus were divided randomly in 2 groups (21 treated by scarf and 22 treated by long chevron osteotomy and 5 were missed during follow up), average age 36 years, follow up time was average of 25.9 months. Patients were assessed clinically, radiologically, and functional scoring system of American College of Foot and ankle Surgeons (ACFAS)was used both pre and postoperatively. Results: Operative time was 69 min in scarf group compared to 63 min to long chevron group, radiological correction showed no statistically significant difference between both groups while functional improvement in ACFAS score was in favour of long chevron group 69.1% compared to scarf group 57.5% Conclusions: Both osteotomies possess almost identical corrective power of the IMA (intermetatarsal angle) and similar clinical outcomes with slightly shorter operative time and subjective technical simplicity for the long chevron osteotomy.