Proximal versus distal metatarsal osteotomies for moderate to severe hallux valgus deformity: a systematic review and meta-analysis of clinical and radiological outcomes

Tsikopoulos, Konstantinos; Papaioannou, Periklis; Kitridis, Dimitrios; Mavridis, Dimitris; Georgiannos, Dimitrios

doi:10.1007/s00264-018-3782-5

Cited by 15 publications

(14 citation statements)

References 30 publications

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“…During recent years, the most commonly used alternative to MSHV is the SO that provides adequate contact between metaphyseal bone surfaces, prevents shortening of the first metatarsal and allows early mobilization [10, 11]. Adequate correction of the hallux valgus is obtained by greater rotation and translation of the plantar-distal fragment [12, 14]. Although SO is relatively easy for fixation, and our study did not find insufferable complications, it is technically demanding that can lead to worsening of symptoms if non-union or avascular necrosis of the first metatarsal head occurs [9, 11, 13].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the plantar fragment excessive rotation may result in an increase in the DMAA that can contribute to a lateral hallux deviation [8]. Although SO is identified by many surgeons for hallux valgus, it is far from a panacea [14]. Traditional SO simply releases the tendinous insertion of the adductor hallucis muscle and tightens the medial capsule.…”

Section: Discussionmentioning

confidence: 99%

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Transfer of abductor hallucis tendon combined with scarf osteotomy versus single scarf osteotomy in moderate to severe hallux valgus deformity: a comparative retrospective cohort study

Xiong

Shen

Cheng

et al. 2019

BMC Musculoskelet Disord

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Background Scarf osteotomy (SO) was broadly applied in moderate to severe hallux valgus (MSHV), and the results were satisfactory. However, due to the complicated pathologic changes in hallux valgus, the ideal surgical treatment is still controversial. Transfer of the abductor hallucis tendon combined with Scarf osteotomy (TAHTCSO) was an innovative alternative technique. This retrospective cohort study aimed to define if TAHTCSO mode resulted in improved outcomes as compared with the single SO in MSHV. Methods Of 73 patients (92 ft) with MSHV, 36 (45 ft) were treated through TAHTCSO and 37 ones (47 ft) through SO. The patients were assessed clinically and radiographically with a 24-month follow-up. They were assessed pre-operatively and post-operatively with intermetatarsal angle (IMA), hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), first metatarsophalangeal joint range of motion (1#MTP ROM), as well as American Orthopaedic Foot and Ankle Society (AOFAS) forefoot scores and postoperative complications of surgery. Results Both cohorts had the same baseline feathures. All patients were followed up from 24 to 40 months, with a mean of 28.3 months. Patients in the TAHTCSO cohort had significantly decreased HVA at 6 months (p < 0.0001), 12 months (p < 0.0001), and 24 months (p < 0.0001) after surgery. 1#MTP had been increased slightly with non-statistic sense (p>0.05). IMA, DMAA and AOFAS also had not significantly difference at all followed time after surgery as compared with the SO cohort. The healing of osteotomies was observed within 8 weeks in the two cohorts. Two cases of hallus varus had been found in SO cohort and there were no cases of delayed healing and bone non-union in both cohorts. Conclusion In this retrospective cohort study, TAHTCSO had sufficient maintenance of the correction and improved functional performance thereby was a good alternative for MSHV, though it did not display a better result for MSHV compared to SO.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Transfer of abductor hallucis tendon combined with scarf osteotomy versus single scarf osteotomy in moderate to severe hallux valgus deformity: a comparative retrospective cohort study

Xiong

Shen

Cheng

et al. 2019

BMC Musculoskelet Disord

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“…On comparing proximal and distal osteotomies, a recent meta-analysis by Tsikopoulos et al. found no significant differences between proximal and distal metatarsal osteotomies (48).…”

Section: Treatment and Complicationsmentioning

confidence: 99%

Clinical and imaging assessment and treatment of hallux valgus

et al. 2019

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Hallux valgus is a common condition estimated to affect as many as 23% of adults. The condition is associated with a variety of debilitating symptoms leading to significant morbidity and quality of life issues. Proper evaluation of this deformity and the timely management of its symptoms can improve hallux valgus-related symptomatology and quality of life. The most commonly used and readily reproduced measurements for assessing hallux valgus are the inter-metatarsal angle and the hallux valgus angle. These angles are helpful for choosing and planning surgical intervention for patients who fail initial conservative measures with distal osteotomies reserved for mild or moderate hallux valgus and proximal osteotomies indicated for more moderate to severe deformities. After reading this review article, readers will gain knowledge of the etiopathogenesis of hallux valgus, measurement parameters, and treatment strategies with representative case examples.

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“…Additionally, a longer lateral aspect of the first metatarsal than the medial aspect of the bone was linked to a higher incidence of hallux valgus [ 4 ]. At least one hundred open surgical techniques have been described in many different papers [ 5 , 6 , 7 ]. The most popular techniques described are Scarf, Ludloff, and chevron.…”

Section: Introductionmentioning

confidence: 99%

“…A second-generation osteotomy was described by Bosch based on Hohmann osteotomy [ 6 , 26 ]. It consisted of a short osteotomy at the metatarsal neck fixed with a K-wire inserted in the proximal canal [ 7 ]. Despite the K-wire fixation, instability at the osteotomy site has been reported [ 27 , 28 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Chevron Osteotomy: A Prospective Randomized Controlled Trial

Dragosloveanu

Popov

Cotor³

et al. 2022

Medicina

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Introduction: Minimally invasive surgical techniques for hallux valgus have gained popularity, showing good results characterized by smaller postoperative scars, less pain, lower infection risk, and fewer wound complications. Given the lack of evidence available in our country regarding this subject, especially about this type of surgical technique, our paper aims to compare open and MIS approaches for chevron osteotomy. We evaluated the outcome and complications after 12 months. Materials and Methods: We undertook a prospective, randomized, controlled, single-center study between October 2017 and December 2020. The patients were randomized into two groups: one group that received percutaneous chevron osteotomy (MIS), and the other, open chevron osteotomy (OC). For clinical assessment, we determined the function and the level of pain using the Visual Analogue Scale (VAS) and The American Orthopaedic Foot and Ankle Surgery score (AOFAS). The VAS scale was measured before the surgical procedure, at discharge, and at 3 weeks, 6 weeks, 6 months, and 12 months after surgery. The AOFAS score was calculated preoperatively and after 6 months. The hallux angle (HVA) and intramedullary angle (IMA) were measured preoperatively, and at 6 weeks, 6 months and 12 months. Results: We included 26 cases in the open chevron osteotomy group (24 female, 2 male) and 24 in the MIS group (24 female, 0 male). Both groups demonstrated improvements regarding the IMA and HVA at the last follow-up without any significant differences between the groups at the final assessment. The VAS showed significantly better post-operative results for the MIS group at discharge (p < 0.001) and 3 weeks (p < 0.001), 6 weeks (p < 0.001), and 6 months (p = 0.004) post-surgery. The AOFAS showed no significant differences either before or after surgery. Four cases with screw prominence were reported, three of which belonged to the MIS group. Only one case with metatarsalgia was found in the OC group. Conclusions: This paper demonstrates that minimally invasive chevron osteotomy has comparable results with open chevron osteotomy, even though surgical time and radiological exposure are significantly longer. More studies are required to evaluate the complications and the risk of recurrences.

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Proximal versus distal metatarsal osteotomies for moderate to severe hallux valgus deformity: a systematic review and meta-analysis of clinical and radiological outcomes

Cited by 15 publications

References 30 publications

Transfer of abductor hallucis tendon combined with scarf osteotomy versus single scarf osteotomy in moderate to severe hallux valgus deformity: a comparative retrospective cohort study

Transfer of abductor hallucis tendon combined with scarf osteotomy versus single scarf osteotomy in moderate to severe hallux valgus deformity: a comparative retrospective cohort study

Clinical and imaging assessment and treatment of hallux valgus

Percutaneous Chevron Osteotomy: A Prospective Randomized Controlled Trial

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