Scarf osteotomy for the treatment of moderate to severe hallux valgus: Analysis of predictors for midterm outcomes and recurrence

Castioni, Davide; Fanelli, Daniele; Gasparini, Giorgio; Iannò, Bruno; Galasso, Olimpio

doi:10.1016/j.fas.2019.05.013

Cited by 20 publications

(22 citation statements)

References 52 publications

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“…Although these gures are slightly higher than those reported by other studies, 65,66,67 our complication rate is acceptable, considering the surgical variability and the lack of appearance of serious complications. Additionally, recurrence is a feared complication after HV surgery, with rates ranging from 3% to 73%, 61,63,68,69 being 4.2% in our study. HV recurrence has been correlated with preoperative HVA, 1-2 IMA, and DMAA.…”

Section: Discussionmentioning

confidence: 54%

“…The differences found in the 1-2 IMA and DMAA angles between types of surgery may be due to the surgeon's decision based on the initial angles. Additionally, the role of BMI in HV surgery outcomes has been previously studied, 62,63 and BMI did not act as a predictor for functional outcomes; thus, patients with obesity should not be excluded from HV surgery. 64 The overall complication rate in our study was 8.4%.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of hallux valgus surgery on improving health-related quality of life: A follow up study

Hernández-Castillejo

Martínez‐Vizcaíno

Álvarez‐Bueno

et al. 2022

Foot and Ankle Surgery

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BackgroundHallus valgus (HV) negatively impacts health-related quality of life (HRQoL). Patient-reported outcome measures (PROMs) are increasingly used in clinical studies of the foot and ankle. We aimed to evaluate the effect of HV surgery on PROMs (i.e., pain scales, general HRQoL, and region-speci c scales) and radiological angles. Additionally, we aimed to determine whether the effect on these outcomes depends on the type of surgery (including open and percutaneous techniques) and if it is in uenced by potential confounding factors (i.e., age, HVA, 1-2 IMA, body mass index (BMI), and distal metatarsal articular angle (DMAA). MethodsThis was a longitudinal prospective study. We collected the clinical data of all patients who underwent surgery for symptomatic HV deformity in the orthopedic department of the Virgen de la Luz Hospital of Cuenca (Spain).The clinical outcomes were assessed using the American Orthopedic Foot and Ankle Society (AOFAS) Hallux metatarsophalangealinterphalangeal (HMI) scale, visual analogue scale (VAS), Manchester Oxford foot questionnaire (MOXFQ), short form health survey (SF-12) and European Quality of Life-5 Dimensions (EQ-5D). ResultsA total of 72 patients (70 women, 97.2%) were included in the study 72 (72 feet).The AOFAS pre-post-surgery score changed from 42.16

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Effectiveness of hallux valgus surgery on improving health-related quality of life: A follow up study

Hernández-Castillejo

Martínez‐Vizcaíno

Álvarez‐Bueno

et al. 2022

Foot and Ankle Surgery

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“…7,21,38 Factors linked to hallux valgus recurrence after scarf osteotomy include surgical experience, first ray instability, preoperative joint incongruence, preoperative HVA, preoperative IMA, preoperative distal metatarsal articular angle, incomplete metatarsal head reduction over the sesamoids, and postoperative noncompliance. 7,9,21,24,38,41 The definition of recurrence in the literature is variable, some report it as an HVA greater than 15 degrees and some an HVA greater than 20 degrees. 7,21 In addition, the postoperative time frame reported for a recurrence is also ill defined.…”

Section: Discussionmentioning

confidence: 99%

Pes Planus Deformity and Its Association With Hallux Valgus Recurrence Following Scarf Osteotomy

et al. 2020

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Background: Hallux valgus recurrence is an unsatisfactory complication, with many causes postulated. This study investigated the effect of pes planus on recurrence after scarf osteotomy. Methods: A total of 183 feet were retrospectively reviewed. All patients were treated with a scarf osteotomy and if required Akin osteotomy. We measured preoperative lateral talus first metatarsal angle (T1MA) to study pes planus; an angle of under −4 degrees was considered pes planus. We measured pre and postoperative hallux valgus angle (HVA), intermetatarsal angle (IMA), and sesamoid location. In total 164 feet were suitable for inclusion, with follow-up of at least 6 months (10 males and 154 females, mean age: 52 years). Results: Recurrence frequency (HVA greater than 15 degrees) was 27 feet (16%). Hallux valgus recurrence was not influenced by gender ( P value = .66) or preoperative IMA ( P value = .48). Preoperative HVA greater than 35 degrees was associated with increased frequency of recurrence ( P value = .004). Those with T1MA less than −10 degrees demonstrated progression in HVA and deterioration in sesamoid location up to 6 months postoperatively ( P value = .038). HVA did not progress beyond 6 months. The prevalence of recurrent hallux valgus with normal T1MA was 1%, in T1MA −4 to −10 degrees it was 29% and in T1MA less than −10 degrees it was 47% ( P value <.001). Breaks in T1MA less than −4 degrees were found at the naviculocuneiform joint in 68% of feet in this series. Conclusion: The prevalence of hallux valgus recurrence correlated with the severity of pes planus. Level of Evidence: Level III, retrospective cohort study.

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“…The congruency the rst MTP joint is all-important for the choice of hallux valgus operation and the postoperative recurrence [1] . The data on the congruency of the MTP joint are quite different [2,3] .…”

Section: Introductionmentioning

confidence: 99%

Radiographic evaluation of the congruency of the first metatarsophalangeal joint in hallux valgus

Li¹,

Xu²,

Tang³

2021

Preprint

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Background The congruency of the first metatarsophalangeal (MTP) joint was extremely important for the selection of operating methods and prognosis, while its radiographic evaluation method was relatively lacking. The purpose of this article was to explore the radiographic indicators for evaluating the congruency of the first MTP joint. Methods The patients who had X-ray of weightbearing in the outpatient system were selected, excluding patients with trauma, deformity, and history of operation. 183 patients with 245 feet were included. The hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), metatarsophalangeal joint angle (MTPJA), congruency index (CI) and tibial sesamoid position (TSP) were measured and do statistical analysis. Results The higher the degree of hallux valgus, the higher the proportion of incongruency of the first MTP joint. Significant differences were found in DMAA, MTPJA and CI between the congruency and incongruency groups of patients with moderate to severe hallux valgus (P < 0.05). The area under curve (AUC) of the receiver operating characteristic(ROC) curve for MTPJA and CI was 0.906 and 0.884, the sensitivity and specificity reached 0.791 and 0.862, 0.949 and 0.644, and the critical values were 10.67 and 0.765 respectively. The correlation test indicated that in the congruency group, DMAA and HVA had positive correlation, but MTPJA, CI and HVA had low correlation coefficients. DMAA and HVA were not correlated in the incongruency group, while MTPJA and HVA were significantly positively correlated, and CI and HVA showed a negative correlation (P < 0.05). Conclusion MTPJA and CI are indicators that can quantitatively evaluate the congruency of the first MTP joint, taking 10° and 0.765 as the demarcation points respectively. Clinically, the congruency of MTP joint should be considered when choosing operating methods for different degrees of hallux valgus, MTPJA and CI can be used as quantitative evaluation indicators.

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Scarf osteotomy for the treatment of moderate to severe hallux valgus: Analysis of predictors for midterm outcomes and recurrence

Cited by 20 publications

References 52 publications

Effectiveness of hallux valgus surgery on improving health-related quality of life: A follow up study

Effectiveness of hallux valgus surgery on improving health-related quality of life: A follow up study

Pes Planus Deformity and Its Association With Hallux Valgus Recurrence Following Scarf Osteotomy

Radiographic evaluation of the congruency of the first metatarsophalangeal joint in hallux valgus

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