scholarly journals Outcomes after Rotation Scarf with Akin Osteotomy for Severe Hallux Valgus

2021 ◽  
Author(s):  
Wenyong Xie ◽  
Hao Lu ◽  
Guicheng Li ◽  
Yusong Yuan ◽  
Yijun Liu ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Valgus Deformity ◽  
Optimal Choice ◽  
Foot Deformities ◽  
Hallux Valgus Deformity ◽  
Valgus Angle ◽  
Akin Osteotomy ◽  
Severe Hallux Valgus

Abstract Background: Hallux valgus is one of the most common foot deformities. Surgical treatment is the optimal choice for moderate to severe hallux valgus deformity. Rotation scarf with Akin osteotomy has become increasingly popular. The purpose of our study is to evaluate the long-term outcomes of rotation scarf with Akin osteotomy on severe hallux valgus. Methods: We conducted a retrospective study of patients with hallux valgus who underwent surgery using rotation scarf with Akin osteotomy in our hospital between June 2014 and January 2020. Anteroposterior and lateral weightbearing X-ray were performed before and after the operation. The parameters evaluated include (1) the hallux valgus angle (HVA), (2) intermetatarsal angle (IMA), (3) distal metatarsal articular angle (DMAA) and (4) tibial sesamoid position (TSP). A visual analog scale (VAS) was used to evaluate the pain level before and at the last follow-up after the operation. American Orthopaedic Foot & Ankle Society (AOFAS) Forefoot Score were assessed before and at the last follow-up after the operation. Patient satisfaction assessment was also conducted at the time. Results: A total of 42 patients with 50 feet met our inclusion criteria. Average age at the time of surgery was 61 ± 9 years. Follow-up data were obtained in all 42 patients. The average follow-up time was 47.4 ± 20 months. All radiological parameteres including HVA, IMA, DMAA and TSP had statistically significant improvement (p < 0.001). The VAS score and AOFAS score was also statistically significant before operation and at the last follow-up after the operation (p < 0.001). There are 41 (82%) feet in patients were very satisfied or satisfied. Conclusion: Rotation scarf with Akin osteotomy is demonstrated to be safe, effective, and feasible for correcting severe hallux valgus. It can obtain good long-term correction with a low incidence of recurrence and metatarsalgia. Postoperative satisfaction and functional recovery of patients are significantly improved.

Scarf Osteotomy for Hallux Valgus Deformity

2010 ◽  
Vol 100 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Jeroen J. K. De Vil ◽  
Peter Van Seymortier ◽  
Willem Bongaerts ◽  
Pieter-Jan De Roo ◽  
Barbara Boone ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Prospective Studies ◽  
Valgus Deformity ◽  
Hallux Valgus Angle ◽  
Intermetatarsal Angle ◽  
Scarf Osteotomy ◽  
Hallux Valgus Deformity ◽  
Valgus Angle ◽  
Severe Hallux Valgus

Background: Scarf midshaft metatarsal osteotomy has become increasingly popular as a treatment option for moderate-to-severe hallux valgus deformities because of its great versatility. Numerous studies on Scarf osteotomy have been published. However, no prospective studies were available until 2002. Since then, only short-term follow-up prospective studies have been published. We present the results of a prospective study of 21 patients treated by Scarf osteotomy for hallux valgus with follow-up of 8 years. Methods: Between August 1, 1999, and October 31, 1999, 23 patients (23 feet) with moderate-to-severe hallux valgus deformity were included. Clinical (American Orthopaedic Foot and Ankle Society score) and radiologic (hallux valgus angle, first intermetatarsal angle, and sesamoid position) evaluations were performed preoperatively and 1 and 8 years postoperatively. Results: Clinical evaluation showed a significant improvement in the mean forefoot score from 47 to 83 (of a possible 100) at 1 year (P &lt; .001). Radiographic evaluation showed significant improvement in the hallux valgus angle (mean improvement, 19°; P &lt; .001) and in the intermetatarsal angle (mean improvement, 6°; P &lt; .001). These clinical and radiographic results were maintained at the final evaluation 8 years postoperatively. Conclusions: Scarf osteotomy tends to provide predictable and sustainable correction of moderate-to-severe hallux valgus deformities. (J Am Podiatr Med Assoc 100(1): 35–40, 2010)

Biplanar Chevron Osteotomy

2002 ◽  
Vol 23 (9) ◽  
pp. 792-798 ◽  
Author(s):  
Caio Nery ◽  
Rui Barroco ◽  
Cibele Réssio
Keyword(s):  
Hallux Valgus ◽  
Valgus Deformity ◽  
Average Score ◽  
Intermetatarsal Angle ◽  
Chevron Osteotomy ◽  
Hallux Valgus Deformity ◽  
Valgus Angle ◽  
Radiological Data ◽  
End Of Treatment

Results of biplanar chevron osteotomy performed on patients with mild-to-moderate hallux valgus deformity with an increased distal metatarsal articular angle (DMAA) are shown. The study included clinical data of 32 patients (54 feet) who had completed a 2-year follow-up, and radiological data of these 32 and other 29 patients (50 feet) for a total of 61 patients (104 feet, 53 right and 51 left). There were 59 females and two males with ages varying from 11 to 66 years. According to the AOFAS Hallux Rating, the preoperative average score (50) improved to 90 (average score after the surgery). The hallux valgus angle was improved from an average of 25° to 14°, the first intermetatarsal angle from 12° to 8° and the DMAA from 15° to 5°. At the end of treatment, 94% of patients were classified as having grade 0 or I sesamoid lateral sub-luxation. Given improvement in angles and 90% of patients satisfied with an average AOFAS postoperative score of 90, the technique seems indicated for treatment of symptomatic hallux valgus deformity with increased DMAA.

Modified Chevron Osteotomy for Hallux Valgus

1994 ◽  
Vol 15 (12) ◽  
pp. 642-645 ◽  
Author(s):  
Richard E. Donnelly ◽  
Charles L. Saltzman ◽  
Todd A. Kile ◽  
Kenneth A. Johnson
Keyword(s):  
Hallux Valgus ◽  
Screw Fixation ◽  
Valgus Deformity ◽  
Chevron Osteotomy ◽  
Hallux Valgus Deformity ◽  
Long Term Follow Up ◽  
Reliable Procedure ◽  
Shoe Wear

The chevron osteotomy for hallux valgus was modified by addition of screw fixation and change of the osteotomy angle. Thirty-six patients underwent this modified osteotomy. All had mild to moderate symptomatic hallux valgus deformities. No other forefoot procedures were performed. Standing radiographs were taken before surgery, at 1 month after surgery, and, for the 15 patients who returned for long-term follow-up, at 1 year or more after surgery. Overall, 35/42 procedures were rated as satisfactory without reservations and 7 were rated as satisfactory with mild reservations. All patients stated that they had some improvement in their preoperative symptoms, which included pain, cosmetic concerns, and shoe wear difficulties. Radiographically, none of the capital fragments displaced and there were no malunions, nonunions, nor evidence of avascular necrosis. The average metatarsophalangeal-1 angle improved 8° and the average intermetatarsal 1–2 angle improved 4°. This modification is relatively simple, increases stability, and allows early weightbearing. In our experience, the modified chevron osteotomy has been a very reliable procedure for mild to moderate symptomatic hallux valgus deformity.

scholarly journals Short Scarf Osteotomy for Hallux Valgus: Short-term and Medium-term Results

2017 ◽  
Vol 4 (1) ◽  
pp. 14-18
Author(s):  
Rajesh Rachha ◽  
Rakesh Dalal ◽  
David Leonard ◽  
Ajay Chourasia ◽  
Saqib Javed
Keyword(s):  
Hallux Valgus ◽  
Operating Time ◽  
Valgus Deformity ◽  
Asia Pacific ◽  
Medium Term ◽  
Short Term ◽  
Scarf Osteotomy ◽  
Hallux Valgus Deformity ◽  
Valgus Angle

ABSTRACT Aim The scarf osteotomy, as popularized by Barouk, is a versatile osteotomy for the correction of moderate and severe hallux valgus deformity. However, this technique requires extensive exposure, fixation, and increased operative time, and is technically demanding. We describe and present our results of a short scarf osteotomy (SSO), which retains all the cuts of a standard scarf but requires a reduced exposure, less metalwork, less operating time, and is more economical. Materials and methods All patients who underwent SSO between January 2010 and December 2012 with minimum follow-up of 12 months were eligible for the study. Preoperative, intraoperative, and postoperative radiographs were available for radiological assessment. Results In this study, 84 patients and 94 feet were included; 90% of patients were satisfied overall, with 83% of patients recommending this surgery to a friend. The hallux valgus angle improved from a preoperative mean of 30.89° (17.4—46.8) to 12° (4—30) postoperatively (p = 0.0001). The intermetatarsal angle improved from a preoperative mean of 15.05° (10.3—21.1) to 7.14° (4—15.1) postoperatively (p = 0.0001). The average sesamoid coverage improved from grade 2.18 (1—3) preoperatively to 0.57 (0—2) postoperatively (p = 0.0001). The average American Orthopedic Foot and Ankle Score improved from 51.26 (32—88) preoperatively to 91.1 (72—100) postoperatively (p = 0.0001). Conclusion We believe that this osteotomy is a novel procedure producing good to excellent results in most cases of hallux valgus. Biologically, the decreased exposure should improve healing and reduce the risk of avascular necrosis. We strongly recommend this osteotomy for most cases of hallux valgus surgery. How to cite this article Dalal R, Rachha R, Leonard D, Chourasia A, Javed S. Short Scarf Osteotomy for Hallux Valgus: Short-term and Medium-term Results. J Foot Ankle Surg (Asia-Pacific) 2017;4(1):14-18.

scholarly journals Is Generalized Ligamentous Laxity a Prognostic Factor for Recurred Hallux Valgus Deformity?

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0018
Author(s):  
Byung-Ki Cho ◽  
Seung-myung Choi
Keyword(s):  
Hallux Valgus ◽  
Postoperative Recurrence ◽  
Valgus Deformity ◽  
Foot And Ankle ◽  
Hallux Valgus Angle ◽  
Ligamentous Laxity ◽  
Chevron Osteotomy ◽  
Hallux Valgus Deformity ◽  
Valgus Angle

Category: Bunion Introduction/Purpose: It is still unclear whether generalized ligamentous laxity is a risk factor for recurred hallux valgus deformity. This study was performed to evaluate the intermediate-term clinical outcomes after proximal chevron osteotomy for hallux valgus in patients with generalized ligamentous laxity, and to determine the effect on postoperative recurrence of deformity. Methods: A total of 198 feet from 169 female patients were treated with a proximal chevron osteotomy for hallux valgus with a mean follow-up of 46.3 months. When generalized ligamentous laxity was defined as Beighton score ≥ 5 points, there were 18 patients (10.7%) in laxity group and 151 patients (89.3%) in non-laxity group. Clinical evaluation consisted of the American Orthopaedic Foot and Ankle Society (AOFAS) scores, Foot and Ankle Ability Measure (FAAM), and radiographic measurement of hallux alignment. Risk factors associated with postoperative recurrence were evaluated using univariate analysis. Results: Recurrence rates were 21.7% in the laxity group and 17.1% in non-laxity group (p = 0.218), when defined as hallux valgus angle ≥ 20°. No significant differences of measurement at final follow-up were found between the 2 groups in terms of AOFAS score, FAAM, recurrence rate, hallux valgus angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA). Preoperative HVA and IMA were found to be predictive factors of recurrence (OR = 6.3, 4.2; P = .001, .018, respectively). Conclusion: There were no statistical differences in the clinical and radiographic outcomes between hallux valgus with and without generalized ligamentous laxity. Generalized ligamentous laxity demonstrated no definitive effects on postoperative recurrence of hallux valgus deformity.

scholarly journals Improvement of Valgus Deviation of the Lesser Toes of Moderate to Severe Hallux Valgus After Proximal Chevron Metatarsal Osteotomy and Akin Osteotomy

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0027
Author(s):  
Hong-Geun Jung ◽  
Hwa Jun Kang ◽  
Juan Agustin Coruna
Keyword(s):  
Hallux Valgus ◽  
Metatarsal Osteotomy ◽  
Metatarsal Angle ◽  
Valgus Angle ◽  
Significant Difference ◽  
Akin Osteotomy ◽  
The Mean ◽  
Severe Hallux Valgus ◽  
Mtp Joints

Category: Lesser Toes Introduction/Purpose: The valgus deviation of lesser toes is often found in the hallux valgus patients. It has been known that valgus deviation of lesser toes remain unchanged even after correction of hallux valgus. The purpose of this study was to determine whether valgus deviation of lesser toes can be corrected after proximal chevron metatarsal osteotomy (PCMO) and Akin osteotomy for the hallux valgus patients, and to evaluate the factors affecting the degree of correction. Methods: The study is based on 116 feet (89 patients) of moderate to severe hallux valgus that underwent proximal chevron metatarsal osteotomy with Akin ostetomy. Hallux valgus angle (HVA), inter-metatarsal angle (IMA), valgus angle of 2nd, 3 rd, 4th metatarso-phalangeal joint were assessed preoperatively and postoperative 6 month, 1 year and yearly. VAS pain cores, American Orthopedic Foot and Ankle Society metatarsophalangeal-interphalangeal (AOFAS MTP-IP) scale and patient satisfaction were evaluated preoperatively and at subsequent follow-up. Results: The average follow-up was 30.6 months (range,12-99). The mean HVA and IMA reduced from 34.4° to 8.7° and 15.9° to 5.3° respectively at the final follow-up. Patients with more severe HVA showed higher degree of valgus deviation of lesser toes than those with lesser HVA. The valgus angle of 2nd,3 rd,4th MTP joints reduced from 8.9°, 6.7°, 2.4° preoperatively to 5.6°, 4.9°, 1.3° respectively at the final follow-up (p<0.05). The more HVA corrected, the more valgus deviation of lesser toe was found corrected. There was no significant difference in the degree of lesser toe correction angle according to follow up period after postoperative 1 year. The mean VAS and AOFAS scores significantly improved from 6.0, 60.9 to 1.2, 92.0 at the final follow-up, respectively (P<0.05). Conclusion: Unlike the previous reports, the current study showed significant reduction of the valgus angle of 2nd, 3 rd, 4th MTP joints after PCMO and Akin osteotomy for the moderate to severe HV without additional corrective lesser toe surgery.

scholarly journals Extended Distal Chevron Osteotomy

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002 ◽  
Author(s):  
Chan Kang ◽  
Jaehwang Song ◽  
Donghun Kang ◽  
Chang-Kyun Noh ◽  
Ahn Ki Jun
Keyword(s):  
Hallux Valgus ◽  
Valgus Deformity ◽  
Plantar Surface ◽  
Chevron Osteotomy ◽  
Hallux Valgus Deformity ◽  
Radiographic Measurements ◽  
Valgus Angle ◽  
Group A ◽  
Group B

Category: Bunion, Midfoot/Forefoot Introduction/Purpose: Numerous corrective osteotomies have been performed for surgical treatment of hallux valgus(HV). One of these procedures is distal chevron osteotomy, traditionally indicated for correction of mild to moderate HV. We proposed a new modification of the chevron osteotomy, extended distal chevron osteotomy, to provide even greater stability by extend the contact surface, as well as more effective and accurate correction of the angulation and rotational profile than conventional osteotomy. Methods: Between July 2013 and June 2014, the extended distal chevron osteotomy (DCO) was performed for the treatment of mild-to-moderate hallux valgus deformity in 63 feet (Group A) by the same surgeon. For the extended chevron, the first osteotomy was performed to cut 5-10 mm from the head of metatarsal to the proximal upper 1/3 of the neck. The second osteotomy was performed to cut 2.5~3.0 cm from the upper 1/3 of the neck toward horizontal plane of the plantar surface with an angle of 45~50 degree. Standard foot radiographic measurements, hallux valgus angle(HVA) and intermetatarsal angle(IMA), were recorded to compare with the values of 37 patients (Group B) who were treated by the traditional DCO technique. Results: Mean patient age was 45.3 (range 15–78) years, and 54 patients were available for follow-up at both one and two years postoperatively. Mean follow-up duration was 13.7 (range 4–26) months. In group A, mean HVA decreased from 32.3° preoperatively to 8.4° at final follow-up, while the angle of group B decreased from 32.4° to 11.4°. Mean IMA decreased from 15.1° preoperatively to 7.3° at final follow-up in group A, while the IMA decreased from 15.1° to 8.9° in group B. That way we could verify that the extended chevron osteotomy is more effective for stability and correcting of the angulation and rotational profile than traditional DCO. Conclusion: The extended chevron osteotomy achieved even greater stability and accurate correction of the deformity. Furthermore, it was more effective than traditional chevron osteotomy in terms of correction of the angulation and rotational profile.

Treatment of Hallux Valgus by Oblique Osteotomy of the First Metatarsal

Foot & Ankle ◽  
1992 ◽  
Vol 13 (8) ◽  
pp. 447-452 ◽  
Author(s):  
Kosaku Mizuno ◽  
Masataka Hashimura ◽  
Mayako Kimura ◽  
Kazushi Hirohata
Keyword(s):  
Hallux Valgus ◽  
Metatarsophalangeal Joint ◽  
Valgus Deformity ◽  
X Rays ◽  
Great Toe ◽  
First Metatarsal ◽  
Oblique Osteotomy ◽  
Hallux Valgus Deformity ◽  
Valgus Angle

This paper describes a simple technique of oblique osteotomy of the first metatarsal for treatment of symptomatic hallux valgus deformity. The osteotomy is performed at a 30° angle from the long axis of the metatarsal shaft. The head of the metatarsal is then displaced laterally to provide correction of the hallux valgus. This is an uncomplicated procedure for the treatment of hallux valgus. From 1984 through 1989, 53 feet in 31 patients were treated with an oblique osteotomy of the first metatarsal. A total of 49 feet in 27 patients were followed up more than 2 years. The follow-up x-rays and clinical examinations revealed a good result in 43 feet. In six feet of three patients, all of whom had simultaneous oblique osteotomies of both the first and second metatarsals, a fair or poor result was obtained. It was learned that oblique osteotomy for hallux valgus greater than 40° provided insufficient correction of the valgus angle or limitation of motion at the metatarsophalangeal joint of the great toe.

scholarly journals First Tarsometatarsal Joint Derotational Arthrodesis for Flexible Hallux Valgus: Results from Follow-Up of 3–8 Years

2017 ◽  
Vol 106 (4) ◽  
pp. 325-331 ◽  
Author(s):  
T. Klemola ◽  
O. Savola ◽  
P. Ohtonen ◽  
R. Ojala ◽  
J. Leppilahti
Keyword(s):  
Confidence Interval ◽  
Hallux Valgus ◽  
Valgus Deformity ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Tarsometatarsal Joint ◽  
Hallux Valgus Deformity ◽  
Valgus Angle ◽  
The Mean

Purpose: We report 3- to 8-year follow-up results for the first tarsometatarsal joint derotational arthrodesis. Methods: A total of 70 patients (88 feet) with symptomatic flexible hallux valgus were operated between 2003 and 2009. In all, 66 patients (94.3%) with 84 (95.5%) feet were enrolled in retrospective analysis; of those, 58 (87.9%) patients with 76 (90.5%) feet were followed for a mean of 5.1 (range: 3.0–8.3) years. Preoperative, 6 week postoperative, and late follow-up weightbearing radiographs were evaluated along with clinical examination and questionnaires. Results: The mean hallux valgus angle improved 13.4° (95% confidence interval: 11.6–15.1, p < .001) at the latest follow-up, while the mean intermetatarsal angle correction was 4.5° (95% confidence interval: 3.7–5.2, p < .001). There were three (4.0%) nonunions, and seven (9.2%) feet needed reoperation during follow-up. Conclusion: First tarsometatarsal joint derotational arthrodesis is an effective procedure for correcting flexible hallux valgus deformity and provides a satisfactory long-term outcome.

Percutaneous Chevron and Akin (PECA) Osteotomies for Severe Hallux Valgus Deformity With Mean 3-Year Follow-up

2021 ◽  
pp. 107110072110084
Author(s):  
Thomas L. Lewis ◽  
Robbie Ray ◽  
Peter Robinson ◽  
Paul M. C. Dearden ◽  
Thomas J. Goff ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Deformity Correction ◽  
Valgus Deformity ◽  
Percutaneous Surgery ◽  
Residual Deformity ◽  
Hallux Valgus Deformity ◽  
Patient Reported ◽  
The Mean ◽  
Severe Hallux Valgus

Background: Patients with severe hallux valgus deformity present technical and operative challenges with high rates of recurrence and residual deformity. The clinical and radiologic outcomes of percutaneous surgery for severe hallux valgus are not known. Methods: A retrospective review of consecutive patients with a hallux valgus angle (HVA) >40 degrees or intermetatarsal angle (IMA) >20 degrees who underwent third-generation percutaneous chevron and Akin osteotomy (PECA) for hallux valgus deformity correction. Results: Between December 2012 and August 2019, 59 feet in 50 patients underwent PECA. Preoperative and follow-up radiographic data were available for 53 feet (89.8%). Postoperative clinical patient-reported outcome measures and satisfaction results were available for 51 feet (86.4%). The mean clinical and radiographic follow-up was 3.1 years and the mean postoperative Manchester-Oxford Foot Questionnaire Index score was 15.1. There was a statistically significant improvement ( P < .001) in both IMA and HVA following surgery (IMA 17.5-5.1 degrees; HVA 44.1-11.5 degrees). All patients reported they were satisfied with their outcome, with 76.8% reporting they were highly satisfied. The hallux valgus recurrence rate was 7.5%. Conclusion: Percutaneous surgery for severe hallux valgus deformity can achieve a large deformity correction, patient satisfaction, and quality of life, with reasonable rates of residual deformity and low rates of recurrence. Level of Evidence: IV

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