Extended plantar limb (modified) chevron osteotomy versus scarf osteotomy for hallux valgus correction: A randomised controlled trial.
BACKGROUND
The purpose of this RCT was to compare the extended plantar limb (modified) chevron osteotomy with the scarf osteotomy in correcting hallux valgus deformity and improving functional scores and patient satisfaction.


METHODS
Patients were randomly assigned and kept blind to surgical allocation. Cases requiring additional procedures including the Akin osteotomy were excluded. Outcomes were measured at 1 year following surgery.


RESULTS
84 patients (109 feet) were analysed (60 modified chevron; 49 Scarf). The mean age was 50.7 years (75F: 9M). Post-operative intermetatarsal angle (IMA) was significantly lower in the modified chevron group (5.8° versus 6.9°, p=0.045). Hallux valgus angle and distal metatarsal articular angle were similar. The magnitude of IMA correction with the modified chevron was also significantly greater (9.1° versus 7.1°, p=0.007). Both osteotomies produced comparable MOxFQ scores and satisfaction ratings.


CONCLUSIONS
The modified chevron was superior to the scarf osteotomy in correcting IMA in hallux valgus deformity.
Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, UK. Electronic address: m.deven@gmail.com.
Devendra
D
Mahadevan
Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, UK.
Stephen
S
Lines
Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, UK.
Stephen
S
Hepple
Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, UK.
Ian
I
Winson
Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, UK.
William
W
Harries
D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D017060:Patient Satisfaction; D020127:Recovery of Function; D016896:Treatment Outcome
Correction; Hallux valgus; Modified chevron; Osteotomy; Scarf