Chevron osteotomy and scarf osteotomy for hallux valgus angle and intermetatarsal angle correction: a systematic review and meta-analysis of randomized controlled trials

• Published in: Journal of orthopaedic surgery and research Vol. 19; no. 1; pp. 566 - 8
• Main Authors: Peng, Yu-Ning, Peng, Yu-Hsiang, Chen, Carl P. C.
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 14.09.2024; BMC
• Subjects: Bunion; Chevron osteotomy; Comparative analysis; Complication; Hallux valgus; Hallux Valgus - diagnostic imaging; Hallux Valgus - surgery; Hallux valgus angle; Humans; Intermetatarsal angle; Metatarsal Bones - diagnostic imaging; Metatarsal Bones - surgery; Osteotomy; Osteotomy - methods; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Randomized Controlled Trials as Topic; Scarf osteotomy; Treatment Outcome; Complication; Hallux valgus; Chevron osteotomy; Hallux valgus angle; Intermetatarsal angle; Scarf osteotomy
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-024-05007-0

This systematic review and meta-analysis aimed to investigate the differences in hallux valgus angle (HVA), intermetatarsal angle (IMA), American Orthopedic Foot and Ankle Society (AOFAS) scores, and complication rates between chevron osteotomy and scarf osteotomy for correcting hallux valgus. Two investigators independently searched for randomized controlled trials (RCTs) published from 2007 to 2018 on PubMed, Web of Science, and Cochrane Library databases. Next, chevron and scarf osteotomies were compared for their postoperative outcomes using HVA, IMA, and AOFAS scores and their complication rates. Meta-analysis was performed using Review Manager (version 5.3). Six RCTs-comprising 507 feet, of which 261 and 246 underwent chevron and scarf osteotomies, respectively-were included. The meta-analysis revealed that chevron osteotomy led to significantly smaller postoperative HVAs than scarf osteotomy (weighted mean difference [WMD] = -1.94, 95% CI = - 2.65 to - 1.29, P < .00001). However, the differences in postoperative IMA (WMD = - 0.44, 95% CI = - 1.10 to 0.22, P = .19), postoperative AOFAS scores (WMD = 0.75; 95% CI = - 5.32 to 6.82; P = .81), and complication rates (risk ratio = 1.22, 95% CI = 0.65-2.27, P = .53) between feet that underwent chevron and scarf osteotomies were nonsignificant. Compared with scarf osteotomy, chevron osteotomy had significantly more favorable postoperative outcomes in terms of HVA correction, but not in terms of IMA, AOFAS scores, or complication rates. Level I, systemic review and meta-analysis.