Clinical Comparison Of Modified Scarf Osteotomy Without Screw Fixation And Traditional Scarf Osteotomy In The Treatment Of Moderate To Severe Hallux Valgus

Objective :To compare the preoperative and postoperative parameters of patients with hallux valgus deformity,and to compare the early clinical outcomes of modified Scarf osteotomy with conventional screw fixation and traditional Scarf osteotomy.Methods: Patients with moderate to severe hallux valgus deformity(50 cases/foot)treated with traditional Scarf osteotomy and modified Scarf osteotomy without screw fixation in the Third Affiliated Hospital of Inner Mongolia Medical University from September 2016 to March 2019 were selected.Subjects,samples were randomly grouped,and controlled experiments.Experimental group: Modified Scarf osteotomy without screw fixation to correct patients with moderate to severe hallux valgus deformity.Control group: Traditional Scarf osteotomy to correct patients with moderate to severe hallux valgus deformity.Subjects voluntarily participated in the study and voluntarily signed informed consent.Each patient had the right to unconditionally and unilaterally suspend the study during the course of the experiment.Informed about the adverse events and possible risks in the experiment.The hallux valgus angle(HVA),the1 st to 2nd intercondylar angle(IMA),and the distal radius of the tibia(DMAA)were measured before,during,and after the last follow-up(average follow-up of 13.5months),sesamoid location,first metatarsal length,first humeral protrusion length,American Foot and Ankle Surgical Society Foot Function Scoring System(AOFAS)score,visual analogue scale(VAS)and mean healing time.Results : 1.In the control group,patients with hallux valgus deformity had no complications such as recurrent hallux valgus recurrence,rotational deformity,metastatic patella pain,loosening of the fixation,infection and first humeral head necrosis.Among them,less than one correction occurred(corrected by secondarysurgery),and internal fixation stimulated 2 feet.The complication rate was 12%.The average healing time was 4.8 weeks.The control group had better HVA,IMA,DMAA,sesamoid position,first tibia length,AOFAS and VAS score than the preoperative.The above data were statistically significant,and the difference was statistically significant(P<0.05).There was no significant difference in the length of the first tibia protrusion before and after surgery(P>0.05).2.Postoperative hallux valgus deformity in patients with hallux valgus recurrence,correction,delayed healing,rotational deformity,metastatic patella pain,infection and first humeral head necrosis.Among them,due to overcorrection,the sacral hallux varus is one foot(already undergoing revision surgery).The average healing time was 4.2 weeks.The HVA,IMA,sesamoid position,first tibia length,first humeral protrusion length,AOFAS and VAS score were better than those before operation in the experimental group,and the difference was statistically significant(P<0.05).There was no significant difference between the preoperative and postoperative DMAA controls(P>0.05).Conclusion : Both the modified Scarf osteotomy without screw fixation and the traditional Scarf osteotomy can improve the symptoms and signs of moderate to severe hallux valgus deformity,postoperative HVA,IMA,DMAA,sesamoid position,AOFAS and VAS score are superior to preoperative.Improved Scarf osteotomy without screw fixation allows for better displacement without maximizing internal fixation,maximally correcting hallux valgus deformity,no secondary surgery costs,good stability,and short healing time And can be maintained for a long time after healing.