Application Of Modified Rotating Scarf Osteotomy Combined With 3D Printed Guide Plate In The Treatment Of Moderate To Severe Hallux Valus

[Objective] To investigate the clinical efficacy of modified rotating Scarf osteotomy combined with 3D printed personalized osteotomy guide in the treatment of moderate to severe Hallux Valgus.[Methods] 148 patients with moderate or severe Hallux Valus who received surgical treatment in our hospital from January 2018 to July 2022 were selected as the research subjects.In the first stage,the clinical data of 100 patients with moderate to severe hallux valus who received surgical treatment in our hospital from January 2018 to June 2019 were retrospectively analyzed.All of them underwent modified rotating Scarf osteotomy.In the second stage,48 patients with moderate or severe Hallux Valour who received surgical treatment in our hospital from July 2021 to July 2022 were selected as the research subjects,and were divided into control group(24 cases)and 3D printing group(24 cases)according to different surgical methods.The control group received conventional modified rotating Scarf osteotomy,and the 3D printing group received modified rotating Scarf osteotomy assisted by3 D printing personalized osteotomy guide.The operation time,intraoperative blood loss,postoperative deformity correction,postoperative foot function and postoperative complications of the two groups were observed and recorded.The valgus Angle(HVA),the Angle between the first and second metatarsals(IMA),the intrinsic Angle of the proximal articular surface(DMAA)and the position of the tibial sesamoid bone were measured by double blind method.The results were evaluated by the American Orthopaedic Foot and Ankle Society(AOFAS)functional scores of the toe,metatarsophalangeal and interphalangeal joints.[Results] The mean follow-up was 12.7 months(6-30 months).Postoperative HVA,IMA,DMAA and positions of tibial sesamoid bone in stage I patients were significantly lower than those before surgery,with statistical significance(P <0.05).AOFAS score at the last follow-up [(94.7±5.8)points] was significantly higher than that before surgery [(45.4±5.1)points],and the difference was statistically significant(P <0.05).Stage 2: Compared with the control group,the 3D printing group had shorter operation time and less intraoperative occurrence,HVA,IMA and DMAA were all smaller than the control group,and AOFAS functional score was higher than the control group.The differences were statistically significant(P<0.05).Patient sufficient ache,appearance,function changes obviously,wear shoe and quality of life get great improvement.[Conclusion] For moderate to severe Hallux Valgus,modified rotating Scarf osteotomy combined with 3D printing personalized osteotomy guide has definite clinical efficacy.