Comparison of the efficacy of modified Chevron osteotomy and Scarf osteotomy in the treatment of moderate to severe hallux valgus
10.7683/xxyxyxb.2024.11.006
- VernacularTitle:改良Chevron截骨术与Scarf截骨术治疗中重度踇外翻疗效比较
- Author:
Zhansheng LI
1
;
Junbo WANG
;
Tan LU
Author Information
1. 新乡医学院第一附属医院手足显微外科,河南 卫辉 453100
- Keywords:
hallux valgus;
modified Chevron osteotomy;
Scarf osteotomy
- From:
Journal of Xinxiang Medical College
2024;41(11):1032-1037
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy of modified Chevron osteotomy and Scarf osteotomy in the treatment of moderate to severe hallux valgus.Methods A total of 76 patients with moderate to severe hallux valgus admitted to the Department of Hand and Foot Microsurgery,the First Affiliated Hospital of Xinxiang Medical University from January 2018 to January 2022 were selected as the research subjects.According to the surgical method,the patients were divided into modified Chevron osteotomy group(n=39,41 feet)and Scarf osteotomy group(n=37 feet).The patients in the modified Chevron osteotomy group received modified Chevron osteotomy treatment,the patients in the Scarf osteotomy group received Scarf osteotomy treatment.The hallux valgus angle(HVA),the 1st and 2nd inter metatarsal angle(IMA)and the distal metatarsal articular angle(DMAA)under weight-bearing conditions of patients in the two groups before and 6 months after surgery were recorded.The orthopedic effect of patients was evaluated by using the American Orthopaedic Foot and Ankle Society(AOFAS)score,and the pain level of patients was evaluated by using the visual analogue scale(VAS)score before and 6 months after surgery.The osteotomy healing time and postoperative complications of patients were compared between the two groups.Results There was no statistically significant difference in HVA,IMA,DMAA and AOFAS,VAS scores of patients before and 6 months after surgery between the two groups(P＞0.05).Six months after surgery,the HVA,IMA,and DM A A of patients in the two groups were significantly lower than those before surgery(P＜0.05),the AOFAS score was significantly higher than that before surgery(P＜0.05),and the VAS score was significantly lower than that before surgery(P＜0.05).The osteotomy healing time of patients in the modified Chevron osteotomy group and Scarf osteotomy group was(3.23±0.49)and(3.49±0.69)months,respectively;there was no statistically significant difference in the osteotomy healing time of patients between the two groups(t=-1.874,P＞0.05).The patients in both groups did not experience any vascular or nerve damage during the surgery,the surgical incision and osteotomy healed in one stage,and there were no complications such as incision infection,delayed osteotomy healing,or nonunion.Two patients(4.9％)in the modified Chevron osteotomy group experienced postoperative metastatic metatarsal pain,and the symptoms were significantly improved after treatment with targeted therapies such as blocking and physical therapy.One patient in each of the two groups experienced discomfort caused by loose internal fixation.The recurrence rates of hallux valgus in the modified Chevron osteotomy group and Scarf osteotomy group were 19.5％(8/41)and 2.6％(1/38),respectively;the recurrence rate of hallux valgus in the Scarf osteotomy group was significantly lower than that in the modified Chevron osteotomy group(x2=5.567,P＜0.05).Conclusion The modified Chevron osteotomy and Scarf osteotomy have similar therapeutic effects in correcting deformities,improving ankle function,and alleviating pain in the treatment of moderate to severe hallux valgus,and both surgical methods have few postoperative complications.However,the recurrence rate of hallux valgus after modified Chevron osteotomy is significantly higher than that after Scarf osteotomy.
