Actual tendencies of Hallux Valgus surgical treatment.

Abstract

The purpose of this study is to evaluate which of the methods selected in patients with moderate or severe hallux valgus a result in a better correction of hallux valgus angle (HVA) and intermetatarsal angle (IMA) in Scarf osteotomy as compared to Chevron osteotomy.
 Material and methods; In our study, we selected 36 patients, 16 scarf and 20 chevron osteotomies, with all surgical options from skin incision, capsular and bunionectomy to bone reorientation. Deformities of patients were classified as mild, moderate and severe according to clinical and radiological findings. The results were measured using radiographic HVA, IMA and distal metatarsal articular angle (DMAA).
 Results: No statistical differences were found in HVA, IMA and DMAA between scarf and chevron osteotomy in mild to moderate hallux valgus. In severe hallux valgus, Scarf osteotomy corrected HVA better than Chevron, although this group consisted of twelve patients. Two patients in the Chevron group and three in the Scarf group developed subluxation of the metatarsophalangeal joint.
 Conclusion: In patients with moderate and severe hallux valgus the results of Scarf and Chevron osteotomy have no specific difference. Change to IMA angle with the subluxation of the first metatarsophalangeal joint some months after operation were the main cause for insufficient correction. We favor the Scarf osteotomy because it is more profitable, with correction of HVA and IMA.