Department of Trauma and Orthopaedic Surgery, T. Marciniak Lower Silesia Specialist Hospital - Emergency Medicine Center, Wroclaw, Poland.
Department of Food Safety and Quality Management, Poznan University of Life Sciences, Poznan, Poland.
J Foot Ankle Surg. 2023 Jul-Aug;62(4):676-682. doi: 10.1053/j.jfas.2023.02.007. Epub 2023 Feb 18.
There is no gold standard in the treatment of hallux valgus deformity. The purpose of our study was to compare various aspects of radiographic assessment following scarf and chevron osteotomies and try to determine which technique helps achieve a more pronounced intermetatarsal angle (IMA) and hallux valgus angle (HVA) correction and produces lower rates of complications, including adjacent-joint arthritis. This study included patients who underwent hallux valgus correction with the scarf (n = 32) or chevron (n = 181) method with a follow-up period of over 3 years. We evaluated the following parameters: HVA, IMA, duration of hospital stay, complications, development of adjacent-joint arthritis. The scarf technique helped achieve a mean HVA and IMA correction of 18.3° and 3.6°, respectively, and the chevron technique helped achieve a mean correction of 13.1° and 3.7°, respectively. The achieved deformity correction in terms of both the HVA and IMA was statistically significant in both patient groups. The loss of correction assessed with the HVA was statistically significant only in the chevron group. Neither group showed a statistically significant loss of IMA correction. The duration of hospital stay, reoperation rates, and fixation instability rates were comparable in the 2 groups. Neither of the evaluated methods caused a significant increase in total arthritis scores in the evaluated joints. Our study showed good outcomes of hallux valgus deformity correction in both evaluated groups; however, scarf osteotomy yielded somewhat better radiographic outcomes in HVA correction and no loss of HVA correction at 3.5 years of follow-up.
在治疗拇外翻畸形方面，目前尚无金标准。我们的研究目的是比较分析 Scarf 和 Chevron 截骨术后的各种影像学评估，并尝试确定哪种技术有助于获得更明显的第一跖骨间角（IMA）和拇外翻角（HVA）矫正，并产生较低的并发症发生率，包括相邻关节关节炎。本研究纳入了接受 Scarf（n=32）或 Chevron（n=181）方法治疗拇外翻畸形且随访时间超过 3 年的患者。我们评估了以下参数：HVA、IMA、住院时间、并发症、相邻关节关节炎的发展。Scarf 技术有助于获得平均 18.3°的 HVA 和 3.6°的 IMA 矫正，Chevron 技术有助于获得平均 13.1°的 HVA 和 3.7°的 IMA 矫正。两组患者的 HVA 和 IMA 畸形矫正程度均有统计学意义。Chevron 组 HVA 矫正丢失有统计学意义。两组 IMA 矫正丢失均无统计学意义。两组的住院时间、再次手术率和固定不稳定性率相当。两种评估方法均未导致评估关节的总关节炎评分显著增加。我们的研究表明，两种评估方法均能获得良好的拇外翻畸形矫正效果；然而，Scarf 截骨术在 HVA 矫正方面的影像学结果略好，且在 3.5 年随访时 HVA 矫正无丢失。
