Foot & Ankle International - July 2016 - (Page 687)
639574
FAIXXX10.1177/1071100716639574Foot & Ankle InternationalJeuken et al
research-article2016
Article
Long-term Follow-up of a Randomized
Controlled Trial Comparing Scarf to
Chevron Osteotomy in Hallux Valgus
Correction
Foot & Ankle International®
2016, Vol. 37(7) 687-695
© The Author(s) 2016
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DOI: 10.1177/1071100716639574
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Ralph M. Jeuken, MD1,2, Martijn G. M. Schotanus, MSc1, Nanne P. Kort, MD, PhD1,
Axel Deenik, MD, PhD3, Bob Jong, MD4, and Roel P. M. Hendrickx, MD1
Abstract
Background: Hallux valgus is one of the most common foot deformities. This long-term follow-up study compared the
results of 2 widely used operative treatments for hallux valgus: the scarf and chevron osteotomy.
Methods: Conventional weight bearing anteroposterior (AP) radiographs of the foot were made for evaluating the
intermetatarsal angle and hallux valgus angle. For clinical evaluation, the American Orthopaedic Foot & Ankle Society
(AOFAS) rating system for the hallux metatarsophalangeal-interphalangeal scale was used together with physical examination
of the foot. These data were compared with the results from the original study. The Short Form 36 questionnaire, the
Manchester-Oxford Foot Questionnaire (MOXFQ), and a general questionnaire including a visual analog scale (VAS) pain
score were used for subjective evaluation. The primary outcome measures were the radiologic recurrence of hallux valgus
and reoperation rate of the same toe. Secondary outcome measures were the results from the radiographs and subjective
and clinical evaluation. The response rate was 76% at the follow-up of 14 years; in the chevron group, 37 feet were included
compared with 36 feet in the scarf group.
Results: Twenty-eight feet in the chevron group and 27 in the scarf group developed recurrence of hallux valgus (P = .483).
One patient in the scarf group had a reoperation of the same toe compared with none in the chevron group (P = .314).
Current VAS pain scores and results from the SF-36, MOXFQ, and AOFAS did not significantly differ between groups.
Conclusion: Both techniques showed similar results after 2 years of follow-up. At 14 years of follow-up, neither technique
was superior in preventing recurrence.
Level of Evidence: Level II, randomized controlled trial.
Keywords: scarf osteotomy, chevron osteotomy, hallux valgus, recurrence
Introduction
One of the most common foot deformities with a prevalence
of 28.4% among adults is hallux valgus (HV).14 Its prevalence is higher in females and increases with age.21 In HV,
there is a structural deformity of the first metatarsophalangeal joint (MTPJ) with lateral deviation of the great toe and
medial deviation of the first metatarsal.30 The etiology is
believed to be multifactorial with both extrinsic factors
such as high-heeled shoes and intrinsic factors such as
genetics contributing to the pathophysiology.25 HV can
impair daily activities and affect quality of life, with common complaints including pain, inability to fit certain shoes,
deformities of the lesser rays, ulceration over the medial
eminence, and cosmetic concerns.15
Numerous non-operative and more than 100 operative
techniques have been described, with operative treatments
varying from distal soft tissue releases to proximal and distal
osteotomies. These operations have been shown to improve
the quality of life. Two widely used and accepted treatments
in HV correction are the chevron and the scarf osteotomy.15
The chevron procedure is a distal V-shaped osteotomy of the
first metatarsal whereas the scarf procedure is a Z-shaped
1
Department of Orthopedic Surgery Zuyderland Hospital, HeerlenSittard, the Netherlands
2
Laboratory for Experimental Orthopedics, MUMC+, Maastricht, the
Netherlands
3
Department of Orthopedic Surgery, Bronovo, the Hague, the
Netherlands
4
Department of Radiology Surgery, Zuyderland Hospital, HeerlenSittard, the Netherlands
Corresponding Author:
Ralph M. Jeuken, MD, Department of Orthopedic Surgery, Zuyderland
Hospital, Heerlen-Sittard, the Netherlands.
Email: r.jeuken@maastrichtuniversity.nl
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Table of Contents for the Digital Edition of Foot & Ankle International - July 2016
TOC/TOC/Verso
Editorial Board
Advertiser Index
Long Term Follow-up of a Randomized Controlled Trial Comparing Scarf to Chevron Osteotomy in Hallux Valgus Correction
Clinical Outcome and Fusion Rate following Simultaneous Subtalar Fusion and Total Ankle Arthoplasty
Anterior Heterotopic Ossification at the Talar Neck After Total Ankle Arthroplasty
Secondary Arthrodesis After Total Ankle Arthroplasty
Functional Outcomes Following First Metatarsophalangeal Arthrodesis
Increased Reduction Clamp Force Associated With Syndesmotic Overcompression
Pain Threshold Tests in Patients With Heel Pain Syndrome
Long-term Results of Chronic Achilles Tendon Ruptures With V-Y Tendon Plasty and Fascia Turndown
Peroneal Tendon Abnormalities on Routine Magnetic Resonance Imaging of the Foot and Ankle
Incisura Morphology as a Risk Factor for Syndesmotic Malreduction
Total Arthroplasty of the Metatarsophalangeal Joint of the Hallux
Ankle Power and Endurance Outcomes Following Isolated Gastrocnemius Recession for Achilles Tendinopathy
Survey of Patient Insurance Status on Access to Specialty Foot and Ankle Care Under the Affordable Care Act
Proximal Gastrocnemius Release in the Treatment of Mechanical Metatarsalgia
Gastrocnemius Proximal Release in the Treatment of Mechanical Metatarsalgia: A Prospective Study of 78 Cases.
Response to "Letter Regarding: Gastrocnemius Proximal Release in the Treatment of Mechanical Metatarsalgia"
The Internal Brace for Midsubstance Achilles Ruptures
The Evolution of Patient Safety
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