Department of Physical Medicine & Rehabilitation, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, 5, Fu-Hsin St., Kwei-Shan, Tao-Yuan, 333343, Taiwan.
Department of Physical Medicine & Rehabilitation, College of Medicine, Chang Gung Memorial Hospital at Taoyuan, Chang Gung University, Guishan District, Taoyuan City, Taiwan.
J Orthop Surg Res. 2024 Sep 14;19(1):566. doi: 10.1186/s13018-024-05007-0.
This systematic review and meta-analysis aimed to investigate the differences in hallux valgus angle (HVA), intermetatarsal angle (IMA), American Orthopedic Foot and Ankle Society (AOFAS) scores, and complication rates between chevron osteotomy and scarf osteotomy for correcting hallux valgus.
Two investigators independently searched for randomized controlled trials (RCTs) published from 2007 to 2018 on PubMed, Web of Science, and Cochrane Library databases. Next, chevron and scarf osteotomies were compared for their postoperative outcomes using HVA, IMA, and AOFAS scores and their complication rates. Meta-analysis was performed using Review Manager (version 5.3).
Six RCTs-comprising 507 feet, of which 261 and 246 underwent chevron and scarf osteotomies, respectively-were included. The meta-analysis revealed that chevron osteotomy led to significantly smaller postoperative HVAs than scarf osteotomy (weighted mean difference [WMD] = -1.94, 95% CI = - 2.65 to - 1.29, P < .00001). However, the differences in postoperative IMA (WMD = - 0.44, 95% CI = - 1.10 to 0.22, P = .19), postoperative AOFAS scores (WMD = 0.75; 95% CI = - 5.32 to 6.82; P = .81), and complication rates (risk ratio = 1.22, 95% CI = 0.65-2.27, P = .53) between feet that underwent chevron and scarf osteotomies were nonsignificant.
Compared with scarf osteotomy, chevron osteotomy had significantly more favorable postoperative outcomes in terms of HVA correction, but not in terms of IMA, AOFAS scores, or complication rates.
Level I, systemic review and meta-analysis.
本系统评价和荟萃分析旨在研究治疗拇外翻时，采用 Chevron 截骨术与 Scarf 截骨术的手术效果差异，包括拇外翻角（HVA）、第一二跖骨间角（IMA）、美国矫形足踝协会（AOFAS）评分和并发症发生率。
两名研究者独立检索 2007 年至 2018 年在 PubMed、Web of Science 和 Cochrane Library 数据库中发表的随机对照试验（RCT）。使用 HVA、IMA 和 AOFAS 评分及并发症发生率比较 Chevron 截骨术与 Scarf 截骨术的术后效果。使用 Review Manager（5.3 版）进行荟萃分析。
纳入 6 项 RCT，共 507 足，其中 Chevron 截骨术 261 足，Scarf 截骨术 246 足。荟萃分析显示 Chevron 截骨术术后 HVA 明显小于 Scarf 截骨术（加权均数差[WMD] = -1.94，95%CI = -2.65 至 -1.29，P <.00001）。但两组术后 IMA（WMD = -0.44，95%CI = -1.10 至 0.22，P =.19）、AOFAS 评分（WMD = 0.75，95%CI = -5.32 至 6.82；P =.81）和并发症发生率（风险比[RR] = 1.22，95%CI = 0.65 至 2.27，P =.53）差异无统计学意义。
与 Scarf 截骨术相比，Chevron 截骨术在术后 HVA 矫正方面具有显著优势，但在 IMA、AOFAS 评分和并发症发生率方面并无明显优势。
I 级，系统评价和荟萃分析。
