Clinical and Radiological Outcomes Comparing Percutaneous Chevron-Akin Osteotomies vs Open Scarf-Akin Osteotomies for Hallux Valgus

Abstract

Level III, retrospective comparative series.

Kramer and Chevron Osteotomy for Hallux Valgus Deformity – Retrospective Comparison of Functional and Radiological Results

“…Since a soft-tissue release was not performed in the present cohort except for 3 cases of the Chevron group, an influence of soft tissue release on the re-centering of the sesamoids cannot be evaluated in this work. Sesamoid configuration does not necessarily influence the functional result [16]. This finding is supported by our study, as significantly better correction of sesamoid position by Kramer osteotomy resulted in a comparable clinical outcome compared to the Chevron group.…”

Minimally invasive Chevron-Akin osteotomy

“…Conventional open surgery for hallux valgus demands extensive dissection of soft tissues and this can result in painful and slow postoperative recovery. A major advantage of minimally invasive surgery is the less painful and more comfortable postoperative course (23,24) . This series adds weight to findings in the literature, with improvement in mean VAS from 8.6 to 1.7 points.…”

Response to “Letter Regarding: Stiffness and Range of Motion After Minimally Invasive Chevron-Akin and Open Scarf-Akin Procedures”

“…We agree that there are differences in technical details. However, there are many variations of MICA and PECA in the literature, 2,5 -7 and we understand MICA as an umbrella term covering all these variations rather than as a narrow term referring specifically to Redfern and Vernois’s particular version of the procedure. The remaining differences between our version of MICA and Redfern and Vernois’s version are irrelevant to the clinical outcome as soon as the bone has healed.…”

“…MIS was found to lead to less pain in the early postoperative phase (and we have cited these papers several times). 5,6 However, pain levels in the early postoperative phase are not the criterion by which operative techniques should be chosen; relevant criteria are the quality of the long-term outcome, the intraoperative safety, and the technical accuracy. Furthermore, it is unclear whether the reported pain reduction of MIS (advertised as an advantage of the method, eg, on the flyer of the course in Miami on 9-10 July 2018) would still be significant if MIS were compared to an open group with incisions smaller than 11 cm, as we did.…”