Comparative Study Of Clinical Outcomes Between Chevron And Scarf Osteotomy For Treatment Of Moderate To Severe Hallux Valgus

Objective: Hallux valgus is the most common forefoot deformity,which has a substantially impact on the patient's walking function and quality of life.Surgery is currently the most important treatment for moderate to severe hallux valgus,including Chevron's and Scarf's osteotomy.To compare the curative effect between Chevron's and Scarf's osteotomy for moderate to severe hallux valgus.Methods: In the Third Hospital of Hebei Medical University,the relevant information was obtained between January 2016 to June 2018 from participates,and a total of 538 participates were diagnosed as Hallux valgus and underwent surgery.Patients aged older than 18 years old,confirmed as moderate to severe hallux valgus on admission,and received Chevron's and Scarf's osteotomy treatment will be screened for inclusion criteria.Exclusion criteria included: age ?18 years old,combined with other disease(such as rheumatoid arthritis,etc),history of hallux valgus surgery(such as fractures,deformity correction,etc),incomplete medical records and loss to follow-up.The radiological,subjective,and objective assessments were collected as indexs.IMA and HMA were used for imaging evaluation,AOFAS score and recurrence rate were used for objective evaluation,in additional,SF-36 questionnaire and VAS pain score were used for subjective evaluation.By using the Pearson's chi-squared test,associations of enumeration data and rate were analyzed.On the other hand,the connection of measurement data was analyzed by T-text.All statistical analyses were conducted using SPSS software,version 22.0(IBM Corp.,Armonk,NY,USA).A p-value < 0.05 was considered statistically significant.Results: Our analysis used 314 feet in 278 patients with a diagnosis of hallux valgus.Among them,194 were in Chevron's osteotomy group(219 feet),84 in Scarf's osteotomy group(95 feet).There were 46 males and 148 females in Chevron's osteotomy group,aged 44 to 68 years old(52.4 ± 9.3),161 feet with moderate hallux valgus,58 feet with severe hallux valgus,with a follow-up period of 12-35 months(17.1 ± 3.1).In additional,17 males and 67 females in Scarf's osteotomy group,aged 36 to 75 years(56.8 ± 8.6),60 feet with moderate hallux valgus,35 feet with severe hallux valgus,with a follow-up period of 11-34 months(15.6 ± 4.0).There was no significant difference in baseline data between the two groups.There was no significant difference in AOFAS,VAS score and SF-36 between the two groups.In contrary,the recurrence rate was 14.4% in Chevron's osteotomy group and 5.3% in Scarf's osteotomy group,which shows statistical difference.There was a statistical difference between the correction value of IMA and that of HVA.Conclusions: The two surgical methods showed the same effect in AOFAS,VAS,SF-36 and other indexes.They are all clinically reliable treatment methods,but the recurrence rate of Chevron's osteotomy group was significantly higher than that of scarf's osteotomy group,the Angle of correction is smaller than the Scarf's group.Therefore,Scarf osteotomy is preferred for severe hallux valgus.