Results of minimally invasive versus open surgery scarf type for correcting moderate and severe hallux valgus. Retrospective observational study.
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Published:
Nov 13, 2018
Keywords:
Hallux valgus, SCARF osteotomy, minimally invasive surgery, complications, AOFAS.
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Abstract
Introduction When pain associated to deformity in hallux valgus is the main symptom and traditional treatment is not effective, then surgical treatment is appropriate. This paper aims to evaluate our experience with minimally invasive technique and osteotomy SCARF-type, with AOFAS-scale and radiologicallyintermetatarsal angle correction, metatarsophalangeal angle, Regnauld scale and Reynolds criteria. Methods.Descriptive observational study retrospective-type. Surgically-handled feet through minimally invasive techniques and SCARF. Pre-surgical clinic information was checked and then 3 to 6 months post-surgery on functionality, imagery findings on three angles and Reynolds and Regnauld classification.Results 123 patients were included who had 150 procedures, minimally invasive surgery (44.7%) and SCARF (55.3%). Average age was 56 years old (IQR 42 – 61 years old), and most interventions were in women (88.6%). No differences between immediate pre-surgery were observed, 3 months and 6 months for intermetatarsalangle between both techniques; moreover, metatarsophalangeal angle was corrected (p=<0.001) and the AOFAS (p=<0.001) was better three months later with the minimally invasive surgery.Discussion Both techniques provide deformity correction to normal values. More and better correction levels were observed in AOFAS for minimally invasive technique with a statistically significant difference. Incidence on acute complications was similar. Clinical essays on this issue are relevant to confirm findings in this study.
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Suárez Zarrate, J. A., Pachon Parrado, C. M., Reyes Copello, J. F., Larota, C. O., Mendoza, D. E., Uribe Medina, J. E., Morales Murillo, J. C., & Rodríguez Serna, S. (2018). Results of minimally invasive versus open surgery scarf type for correcting moderate and severe hallux valgus. Retrospective observational study. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 83(4), 233-241. https://doi.org/10.15417/issn.1852-7434.2018.83.4.765
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Clinical Research
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Rev Venez Cir Ortop Traumatol 2013;45(1):48-52. http://www.svcot.web.ve/html/detalleContenido.php?id=41
14. Bauer T, Biau D, Lortat-Jacob A, Hardy P. Percutaneous hallux valgus correction using the Reverdin-Isham osteotomy. Orthop
Traumatol Surg Res 2010;96:407-41. doi: 10.1016/j.otsr.2010.01.007
15. Suger G. Minimally-invasive surgery of the forefoot: correction on the first ray. Fuβ&Sprunggelenk 2013;11(2):59-69.
doi:10.1016/j.fuspru.2013.02.008
16. Srivastava S, Chockalingam N, El Fakhri T. Radiographic measurements of hallux angles: a review of current techniques.
Foot (Edinb) 2012;20(1):27-31. doi: 10.1016/j.foot.2009.12.002
17. Barouk LS. Scarf and first toe osteotomies in the treatment of hallux valgus. En: Barouk LS. Forefoot reconstruction, 2nd ed.
Paris: Springer-Verlag; 2005:19-114.
18. de Prado M, Ripoll PL, Vaquero J, Golanó P. Tratamiento quirúrgico percutáneo del hallux valgus mediante osteotomías
múltiples. Rev Ortop Traumatol 2003;47(6):406-16. doi: 10.1016/S1888-4415(03)76145-1
19. Bauer T, de Lavigne C, Biau D, De Prado M, Isham S, Laffenétre O. Percutaneous hallux valgus surgery: a prospective multicenter
study of 189 cases. Orthop Clin North Am 2009;40:505-14. doi: 10.1016/j.ocl.2009.05.002
20. Schneider W. Distal soft tissue procedure in hallux valgus surgery: biomechanical background and technique. Int Orthop 2013;
37(9):1669-75. doi: 10.1007/s00264-013-1959-5
21. Shahid MS, Lee P, Evans S, Thomas R. A comparative study of bone shortening and bone loss with use of saw blades versus burr
in hallux valgus surgery. Foot Ankle Surg 2012;18(3):195-7. doi: 10.1016/j.fas.2011.11.001
22. Giannini S, Ceccarelli F, Bevoni R, Vannini F. Hallux valgus surgery: the minimally invasive bunion correction (SERI). Tech Foot
Ankle Surg 2003;2(1):11-20. doi: 10.1097/00132587-200303000-00003
23. Maffulli N, Longo UG, Marinozzi A, Denaro V. Hallux valgus: effectiveness and safety of minimally invasive surgery. A systematic
review. Br Med Bull 2011;97:149-67. doi: 10.1093/bmb/ldq027
Traumatología, 2011:11-33.
2. Coughlin MJ, Mann RA. Hallux valgus. En: Coughlin MJ, Mann RA, Saltzman CL (eds). Surgery of the foot and ankle, 8th ed.
Philadelphia, PA: Mosby Elsevier, 2007:183-362.
3. Kerr J. Scarf-Akin osteotomy correction for hallux valgus: short-term results from a District General Hospital. J Foot Ankle Surg
2010;49:16-9. doi: 10.1053/j.jfas.2009.07.024
4. Carranza A, Macewira E, Viladot R. Estado actual de la cirugía del hallux valgus. Cursos de Actualización, 37º Congreso Nacional
SECOT, Madrid, 2000.
5. Hecht L. Hallux valgus. Med Clin North Am 2014;98:227-32. doi: 10.1016/j.mcna.2013.10.007
6. Oliva F, Longo G, Maffulli N. Minimally invasive hallux valgus correction. En: Maffulli N, Easley M (eds). Minimally invasive
surgery of the foot and ankle, New York, NY: Springer; 2011.
7. Akin OF. The treatment of hallux valgus: A new operative procedure and its results. Med Sentinal 1925;33:678-9.
8. Fuhrmann RA, Zollinger-Kies H, Kundert HP. Mid-term results of scarfosteotomy in hallux valgus. Int Orthop 2010;34(7):981-9.
doi:10.1007/s00264-010-0958-z
9. Leemrijse T, Maestro M, Tribak K, Gombault V, Devos Bevernage B, Deleu PA. Scarf osteotomy without internal fixation to
correct hallux valgus. Orthop Traumatol Surg Res 2012;98:921-7. doi: 10.1016/j.otsr.2012.07.008
10. Myerson MS. Management of complications after correction of hallux valgus. En: Myerson MS, Kadakia AR (eds) Reconstructive
foot and ankle surgery: management of complications, 2nd ed. Philadelphia: Saunders; 2010.
11. Reyes F, Reyes A. Combined miniopen and percutaneous technique for hallux valgus correction: video AAOS 2014, Clínica
Universitaria Colombia, Bogotá, Colombia. https://bit.ly/2Awav7T
12. Bauer T. Percutaneous forefoot surgery. Orthop Traumatol Surg Res 2014;100(1 Suppl):S191-S204.
doi: 10.1016/j.otsr.2013.06.017
13. Albornoz JC, Machuca M. Cirugía percutánea de hallux valgus: experiencia en 56 casos en la Policlínica Méndez Gimón.
Rev Venez Cir Ortop Traumatol 2013;45(1):48-52. http://www.svcot.web.ve/html/detalleContenido.php?id=41
14. Bauer T, Biau D, Lortat-Jacob A, Hardy P. Percutaneous hallux valgus correction using the Reverdin-Isham osteotomy. Orthop
Traumatol Surg Res 2010;96:407-41. doi: 10.1016/j.otsr.2010.01.007
15. Suger G. Minimally-invasive surgery of the forefoot: correction on the first ray. Fuβ&Sprunggelenk 2013;11(2):59-69.
doi:10.1016/j.fuspru.2013.02.008
16. Srivastava S, Chockalingam N, El Fakhri T. Radiographic measurements of hallux angles: a review of current techniques.
Foot (Edinb) 2012;20(1):27-31. doi: 10.1016/j.foot.2009.12.002
17. Barouk LS. Scarf and first toe osteotomies in the treatment of hallux valgus. En: Barouk LS. Forefoot reconstruction, 2nd ed.
Paris: Springer-Verlag; 2005:19-114.
18. de Prado M, Ripoll PL, Vaquero J, Golanó P. Tratamiento quirúrgico percutáneo del hallux valgus mediante osteotomías
múltiples. Rev Ortop Traumatol 2003;47(6):406-16. doi: 10.1016/S1888-4415(03)76145-1
19. Bauer T, de Lavigne C, Biau D, De Prado M, Isham S, Laffenétre O. Percutaneous hallux valgus surgery: a prospective multicenter
study of 189 cases. Orthop Clin North Am 2009;40:505-14. doi: 10.1016/j.ocl.2009.05.002
20. Schneider W. Distal soft tissue procedure in hallux valgus surgery: biomechanical background and technique. Int Orthop 2013;
37(9):1669-75. doi: 10.1007/s00264-013-1959-5
21. Shahid MS, Lee P, Evans S, Thomas R. A comparative study of bone shortening and bone loss with use of saw blades versus burr
in hallux valgus surgery. Foot Ankle Surg 2012;18(3):195-7. doi: 10.1016/j.fas.2011.11.001
22. Giannini S, Ceccarelli F, Bevoni R, Vannini F. Hallux valgus surgery: the minimally invasive bunion correction (SERI). Tech Foot
Ankle Surg 2003;2(1):11-20. doi: 10.1097/00132587-200303000-00003
23. Maffulli N, Longo UG, Marinozzi A, Denaro V. Hallux valgus: effectiveness and safety of minimally invasive surgery. A systematic
review. Br Med Bull 2011;97:149-67. doi: 10.1093/bmb/ldq027