Comparison of Scarf-Akin osteotomy with Lapidus-Akin fusion in cases of Hallux Valgus with a disrupted Meary's line: A case series study.

BACKGROUND

Hallux Valgus associated with medial column instability (disrupted Meary's line) can be corrected either with Lapidus-Akin or Scarf-Akin procedure. This study compares these two procedures to ascertain if type of surgical procedure performed affects the correction achieved and recurrence rate at 6 months following operative intervention.

MATERIALS AND METHODS

This is a retrospective case series that reviews the incidence of early recurrence of Hallux Valgus deformity in 60 patients with an associated disrupted Meary's line who underwent either a Scarf-Akin osteotomy (n = 30) or a Lapidus-Akin procedure (n = 30) between January 2014 and January 2020. Radiographs, operative and clinical notes were utilized to determine degree of correction and recurrence of deformity at 6 months between both groups.

RESULTS

The study found a 47% higher recurrence rate in the Scarf-Akin osteotomy group compared to the Lapidus-Akin group at 6 month follow up. This result was statistically significant with a p-value of 0.002 (95% CI 7-49%). Lapidus-Akin procedure was also found to be superior to the Scarf-Akin procedure in achieving a better degree of correction in the Hallux Valgus angle by an average of 11 degrees.

CONCLUSION

A disrupted Meary's line is a risk factor for recurrence of Hallux Valgus deformity. The authors recommend that Lapidus-Akin procedure has a significantly reduced recurrence rate compared to a Scarf-Akin osteotomy in Hallux Valgus with disrupted Meary's line.