title: Comparative study of scarf and extended chevron osteotomies for correction of hallux valgus.
abstract: BACKGROUND
  Scarf and chevron osteotomies are two described treatments for the correction of hallux valgus deformity, but they have traditionally been employed for different levels of severity. We hypothesized that there would be no statistically significant difference between the results of these two treatments.
  
  
  METHODS
  This study is a retrospective review of 70 consecutive patients treated operatively for moderate and severe hallux valgus malalignment. The two groups based on their operative treatment: scarf osteotomy (Group A) and extended chevron osteotomy (Group B). Preoperative and postoperative hallux valgus angle (HVA), intermetatarsal angle and distal metatarsal articular angle (DMAA) were measured at final follow-up. Charts were also assessed to determine the postoperative rate of satisfaction, stiffness, and pain.
  
  
  RESULTS
  There were no statistically significant differences between Groups A and B with regard to the HVA preoperatively and postoperatively. The DMAA was statistically significantly higher for Group B both preoperatively (p=0.0403) and postoperatively (p<0.0001). The differences in HVA correction and IMA correction were not statistically significant. There were no statistically significant differences with regard to post-operative stiffness, pain, and satisfaction.
  
  
  CONCLUSIONS
  The scarf and extended chevron osteotomies are capable of adequately reducing the HVA and IMA in patients with moderate to severe hallux valgus. These two techniques yielded similar patient outcomes in terms of stiffness, pain and satisfaction. Based on these results, we recommend both the scarf and extended chevron osteotomy as acceptable forms of correction for moderate to severe hallux valgus.
authors.affiliation: Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island (BGV, CRL, CWD).
authors.forename: Bryan G
authors.initials: BG
authors.lastname: Vopat
authors.forename: Craig R
authors.initials: CR
authors.lastname: Lareau
authors.forename: Julie
authors.initials: J
authors.lastname: Johnson
authors.forename: Steven E
authors.initials: SE
authors.lastname: Reinert
authors.forename: Christopher W
authors.initials: CW
authors.lastname: DiGiovanni
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D011300:Preoperative Care / Q000379:methods; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: extended chevron osteotomy; hallux valgus; scarf osteotomy