Abstract
The objective of the study is to compare the radiographic and clinical results of two techniques for the treatment of hallux valgus that have the same indication, the open scarf/Akin (SA) technique and the percutaneous Chevron/Akin (PECA). A meta-analysis was performed with the studies found during a systematic review of articles included in electronic databases until 30 May 2020. The pooled analysis was summarized according to clinical outcomes, such as visual analog pain scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) score, radiographic outcomes and complications, with a 95% confidence interval. Three studies comparing the open scarf/Akin (SA) versus the PECA techniques were added to the analysis, corresponding to 235 feet, 102 in the PECA group and 133 in the SA. The final mean difference in the hallux valgus angle was 0.80 degrees and in the intermetatarsal angle 0.53, in the last radiographic evaluation. In the AOFAS score, the final mean difference was 4.97 points and in the VAS 0.14 in relation to the last clinical evaluation. Exposure to radiation during the surgical procedure was higher in the PECA group with a mean of 35.53 seconds. The PECA surgical technique for the treatment of hallux valgus when compared with SA demonstrated similar radiographic correction, pain and function after six months of follow-up but with a longer radiation exposure time. CRD42018096613.
Highlights
Hallux valgus is a widely studied deformity that affects the feet, and even though more than 130 conventional techniques have been described for its correction, the best technique has not yet been determined [1].One of the most commonly used techniques is open scarf/Akin (SA) osteotomy, which is performed through a medial approach in the forefoot and uses screw fixation to achieve absolute stability [2]
Three studies comparing the open scarf/Akin (SA) versus the percutaneous Chevron/Akin (PECA) techniques were added to the analysis, corresponding to 235 feet, 102 in the PECA group and 133 in the SA
The PECA surgical technique for the treatment of hallux valgus when compared with SA demonstrated similar radiographic correction, pain and function after six months of follow-up but with a longer radiation exposure time
Summary
Hallux valgus is a widely studied deformity that affects the feet, and even though more than 130 conventional techniques have been described for its correction, the best technique has not yet been determined [1].One of the most commonly used techniques is open scarf/Akin (SA) osteotomy, which is performed through a medial approach in the forefoot and uses screw fixation to achieve absolute stability [2]. The results described are satisfactory; residual complains are reported in open surgery by approximately 15% of patients and include intense postoperative pain, slow recovery and stiffness [3,4,5,6]. This result led to a search for research on alternative methods for hallux valgus correction, and the concepts of minimally invasive surgery have been employed, increasing the number of publications on the subject in recent years [7,8].
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