Hallux Valgus Correction Comparing Percutaneous Chevron/Akin (PECA) and Open Scarf/Akin Osteotomies

Lee, Moses; Walsh, James; Smith, Margaret M.; Ling, Jeff; Wines, Andrew; Lam, Peter

doi:10.1177/1071100717704941

Cited by 126 publications

(171 citation statements)

References 38 publications

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“…Uma possível complicação encontrada na queilectomia pela técnica cirúrgica percutânea é a lesão do nervo cutâneo dorsomedial, podendo ser encontrado em até 15% dos casos, segundo um estudo realizado em cadáveres (23) . Entretanto, no presente estudo, não foram observados sinais de hipoestesia em nenhum caso operado.…”

Section: Discussionunclassified

“…Ainda não existem trabalhos comparando o nível de dor pós-operatória nos pacientes submetidos à cirurgia aberta ou percutânea para hálux rígido, porém o trabalho prospectivo randomizado publicado por Lee et al (23) , demonstrou uma signifitiva redução da dor pós-operatória nos casos abordados de hálux valgo pelo Chevron percutâneo, em relação ao Scarf.…”

Section: Discussionunclassified

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Percutaneous cheilectomy combined with Watermann and Moberg osteotomies for the treatment of hallux rigidus

Arruda

Baptista

2019

Sci J Foot Ankle

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Objective: To evaluate the clinical and functional outcomes of patients subjected to surgical treatment of hallux rigidus by the percutaneous cheilectomy combined with Watermann and Moberg osteotomies. Methods: Between May 2017 and August 2018, the clinical outcomes of 7 patients with a diagnosis of hallux rigidus (HR) treated using the percutaneous technique were assessed using the American Orthopedic Foot and Ankle Society (AOFAS) scale, the visual analogue scale (VAS) for pain and hallux metatarsophalangeal joint range of motion measurements during the pre- and postoperative periods. Clinical and functional outcomes were followed up for a minimum of 6 months (mean of 8 months). Results: The range of motion of the metatarsophalangeal joint during the pre- and postoperative periods showed the following results: dorsiflexion increased on average from 28.00º (± 15.63) to 44.43º (± 17.33) (p = 0.006), demonstrating an effective gain in dorsal articular movement. Plantar flexion ranged on average from 27.43º (± 2.22) to 24.43º (± 5.28) (p = 0.228), with no significant difference between the evaluated periods. The AOFAS score increased on average from 52.71 (± 9.63) to 88.00 (± 8.10) (p < 0.01), representing important functional improvement. The VAS score decreased on average from 7.00 (± 1.52) to 2.14 (± 2.19) (p = 0.002), indicating a significant improvement in patient pain. No patient presented postoperative complications. Conclusion: The results of the present study demonstrated that cheilectomy combined with percutaneous Watermann and Moberg osteotomies is an effective surgical treatment for hallux rigidus, with satisfactory clinical and functional outcomes. Level of Evidence IV; Therapeutic Studies; Case Series.

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Section: Discussionunclassified

Percutaneous cheilectomy combined with Watermann and Moberg osteotomies for the treatment of hallux rigidus

Arruda

Baptista

2019

Sci J Foot Ankle

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“…One study was excluded because it's retrospective article and one for the format of continuous variables outcome were not mean±SD.Therefore, five studies matched the selection criteria and were suitable for meta-analysis. [9][10][11][12][13] They are all randomized control trials (Figure 1 osteotomy could achieved better HVA degree compared Scarf osteotomy,but in some researches the results showed that scarf osteotomy was expected to correct moderate and severe hallux valgus better than chevron osteotomy. 14,15 Because in our study only two articles described different severity of the hallux valgus deformity,and one investigator divided the group into three subgroups base on the severity of hallux valgus,so we haven't evaluated the difference in moderate and severe hallux valgus,but we thought the classification of hallux valgus is necessary in the future researches which will indicate the effective of the different type of osteotomy procedures.…”

Section: Literature Searchmentioning

confidence: 99%

Comparison of the clinical outcomes of Scarf and Chevron Osteotomy for Hallux Valgus Deformity: a meta-analysis of randomized controlled trial

Ye¹,

Liu²,

Liu³

et al. 2019

Preprint

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Background Scarf and Chevron Osteotomy have been widely used for Hallux Valgus Deformity (HVD) to correcting hallux valgus angle (HVA) and intermetatarsal 1-2 angle (IMA), but there still have controversy which approach is the best way to repair HVD,this study aims to use meta-analysis to evaluate the clinical outcomes of Scarf and Chevron Osteotomy for Hallux Valgus Deformity.Methods Pubmed, Embase, Medline and Cochrane library databases were searched for relevant studies published before September 1, 2019. Studies clearly reporting a comparison of Scarf and Chevron Osteotomy for Hallux Valgus Deformity were selected. The Post-operative hallux valgus angle (HVA) and intermetatarsal 1-2 angle (IMA) were evaluated and also the correction of HVA and IMA. The weighted mean differences and relative risks were calculated using a fixed-effects or random-effects model.Results Five studies were included in this meta-analysis,one were prospective randomized controlled trials and three were randomized control trials.A total of 434 patients (210 Scarf and 224 Chevron) were enrolled in the studies.Compare Scarf Osteotomy,Chevron Osteotomy can significantly decreaseed Post-operative hallux valgus angle (HVA)[MD = 1.92 95% CI (1.21 to 2.63),P < 0.0001],but there have no significantly difference between Scarf and Chevron Osteotomy groups in terms of Postoperative intermetatarsal angle (IMA),the correction of IMA and HVA(C-

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“…Forefoot MIS has experienced a vertiginous and sustained growth especially in the last decade. Clinical series and comparative studies have been published [47][48][49][50]. Additionally, cadaveric results [51,52], technique reports [53], and radiological validations [54,55] have been described.…”

Section: Current Situation and Indicationsmentioning

confidence: 99%

“…Additionally, cadaveric results [51,52], technique reports [53], and radiological validations [54,55] have been described. Despite the fact that for some authors percutaneous surgery of the forefoot lacks scientific support [56][57][58], recently two systematic reviews published support its indication in hallux valgus surgery [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59].…”

Section: Current Situation and Indicationsmentioning

confidence: 99%

Third-Generation Percutaneous Forefoot Surgery

Vecchio¹,

Dalmau-Pastor²,

EstebanGhioldi³

2018

Update in Management of Foot and Ankle Disorders

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Hallux valgus is one of the most common diseases that affects the foot. The primary symptom of this disease is usually pain. Although non-operative treatment should be attempted, some patients eventually need surgical treatment. There are numerous surgical procedures for correction of HV deformities. Some of these surgeries may be performed through open or percutaneous surgery (MIS). Distal metatarsal chevron osteotomy is an excellent treatment option in mild-to-moderate deformities, providing good results in the correction of deformities and symptoms. This technique can also be done by percutaneous or MIS surgeries; the set of these surgeries are called Third generation procedures. They have been showed to be useful, effective and (maybe) easier than open procedures.

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Hallux Valgus Correction Comparing Percutaneous Chevron/Akin (PECA) and Open Scarf/Akin Osteotomies

Abstract: Both groups showed comparable good to excellent clinical and radiologic outcomes at final follow-up. However, the PECA group had significantly less pain in the first 6 weeks following surgery. Level of Evidence Level II, prospective comparative study.

Cited by 126 publications

References 38 publications

Percutaneous cheilectomy combined with Watermann and Moberg osteotomies for the treatment of hallux rigidus

Percutaneous cheilectomy combined with Watermann and Moberg osteotomies for the treatment of hallux rigidus

Comparison of the clinical outcomes of Scarf and Chevron Osteotomy for Hallux Valgus Deformity: a meta-analysis of randomized controlled trial

Third-Generation Percutaneous Forefoot Surgery

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