Analysis of medium-term outcomes after surgical correction hallux valgus deformity

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Abstract

BACKGROUND: One of the most prevalent foot abnormalities is valgus deformity of the first toe. Many procedures have been proposed to correct this deformity, but one of the most Scarf osteotomy of the first metatarsal bone, which is complemented by the Akin osteotomy of the proximal phalanx of the first finger, is one of the most widely used. This publication analyzes the mid-term effect of repairing the deformity of the first toe using the methods described above.

AIMS: To evaluate the mid-term outcomes of hallux valgus correction using Scarf osteotomy and the combination of Scarf and Akin osteotomies to the literature.

MATERIALS AND METHODS: This is a cross-sectional, observational study. From January to December 2017, 129 patients (147 ft.) received forefoot deformity. Clinical and radiographic parameters were studied using the AOFAS, FFI, and VAS scales and questions related to the subjective assessment of patients by the treatment.

RESULTS: The study’s findings revealed an increase in AOFAS scores from 59.0 (16–88, SD=18.6) before surgery to 85.0 (53–100, SD=13.3; p <0.001) 5 yr later. The VAS scores fell from 5.7 (0–10, SD=2.2) to 2.4 (0–5, SD=1.4; p <0.001). After surgery, the FFI scale score decreased from 40.9 (10–78, SD=18.1) to 11.3 (0–19, SD=5.0; p <0.001). According to the survey, 96.7% of patients would agree to a second operation, 96.9% of those who had surgery would recommend it to their relatives, and 94.6% were satisfied with the aesthetic result of the operation. Most patients (95.4%) were satisfied with the treatment in terms of the disappearance of pain and discomfort. The functional results of the surgical surgery were satisfactory to 98.4% of the patients who were consulted. Radiographic HVA, IMA angle, and Hardy and Clapham sesamoid position scores all indicated favorable mid-term outcomes with no deformity recurrence. In 46.3% of patients (68 patients), there was limited mobility in the first metatarsophalangeal joint. A complication in superficial soft tissue irritation occurred in four patients (2.7%). Iatrogenic varus deviation of one toe was observed in one patient. Metal fixators were removed from patients in 34 patients (23.1%). The removal was completed within a year in 17 cases (11.6%).

CONCLUSIONS: Scarf osteotomy, alone or in combination with Akin osteotomy, is a successful treatment for hallux valgus.

About the authors

Alexander V. Skrebtsov

Yudin City Clinical Hospital

Author for correspondence.
Email: Skrebtsovalex@mail.ru
ORCID iD: 0000-0002-1418-3368
SPIN-code: 3682-4569

Traumatologist-Orthopedist

Russian Federation, Moscow

Victoria K. Nikitina

Yudin City Clinical Hospital

Email: vcnikitina@gmail.com
ORCID iD: 0000-0002-0064-3175
SPIN-code: 9868-0332

Traumatologist-Orthopedist

Russian Federation, Moscow

Victor G. Protsko

Russian Peoples’ Friendship University; Yudin City Clinical Hospital

Email: 89035586679@mail.ru
ORCID iD: 0000-0002-5077-2186
SPIN-code: 4628-7919

MD, Dr. Sci. (Med.), Professor of the Department, Traumatologist-Orthopedist

Russian Federation, Moscow; Moscow

Sargon K. Tamoev

Yudin City Clinical Hospital

Email: sargonik@mail.ru
ORCID iD: 0000-0001-8748-0059
SPIN-code: 2986-1390

MD, Cand. Sci. (Med.); Traumatologist-Orthopedist

Russian Federation, Moscow

Vladimir V. Skrebtsov

Yudin City Clinical Hospital

Email: Skrebtsov@mail.ru
ORCID iD: 0000-0003-0833-6628
SPIN-code: 6002-7102

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Denis S. Yakushev

Federal Scientific and Clinical Center of Specialized Types of Medical Care and Medical Technologies

Email: Orthoped.1@mail.ru
ORCID iD: 0000-0002-6268-9734
SPIN-code: 3242-0683

Traumatologist-Orthopedist

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Valgus deformity of the first ray of both feet.

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3. Fig. 2. Radiographs of feet 5 years after the surgical treatment. Screws removed from the 1st metatarsal bones of both feet.

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