title: Long-term Follow-up of a Randomized Controlled Trial Comparing Scarf to Chevron Osteotomy in Hallux Valgus Correction.
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.
  
  
  CONCLUSIONS
  Both techniques showed similar results after 2 years of follow-up. At 14 years of follow-up, neither technique was superior in preventing recurrence.
  
  
  METHODS
  Level II, randomized controlled trial.
authors.affiliation: Department of Orthopedic Surgery Zuyderland Hospital, Heerlen-Sittard, the Netherlands Laboratory for Experimental Orthopedics, MUMC+, Maastricht, the Netherlands r.jeuken@maastrichtuniversity.nl.
authors.forename: Ralph M
authors.initials: RM
authors.lastname: Jeuken
authors.affiliation: Department of Orthopedic Surgery Zuyderland Hospital, Heerlen-Sittard, the Netherlands.
authors.forename: Martijn G M
authors.initials: MG
authors.lastname: Schotanus
authors.affiliation: Department of Orthopedic Surgery Zuyderland Hospital, Heerlen-Sittard, the Netherlands.
authors.forename: Nanne P
authors.initials: NP
authors.lastname: Kort
authors.affiliation: Department of Orthopedic Surgery, Bronovo, the Hague, the Netherlands.
authors.forename: Axel
authors.initials: A
authors.lastname: Deenik
authors.affiliation: Department of Radiology Surgery, Zuyderland Hospital, Heerlen-Sittard, the Netherlands.
authors.forename: Bob
authors.initials: B
authors.lastname: Jong
authors.affiliation: Department of Orthopedic Surgery Zuyderland Hospital, Heerlen-Sittard, the Netherlands.
authors.forename: Roel P M
authors.initials: RP
authors.lastname: Hendrickx
mesh_terms: D006801:Humans; D005500:Follow-Up Studies; D005528:Foot / Q000502:physiology; D006215:Hallux Valgus / Q000601:surgery / Q000628:therapy; D009985:Orthopedics; D010027:Osteotomy / Q000379:methods; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: chevron osteotomy; hallux valgus; recurrence; scarf osteotomy