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Meta-Analysis
. 2024 Sep 14;19(1):566.
doi: 10.1186/s13018-024-05007-0.

Chevron osteotomy and scarf osteotomy for hallux valgus angle and intermetatarsal angle correction: a systematic review and meta-analysis of randomized controlled trials

Yu-Ning Peng #  1   2 , Yu-Hsiang Peng #  3 , Carl P C Chen  4   5
Affiliations
Meta-Analysis

Chevron osteotomy and scarf osteotomy for hallux valgus angle and intermetatarsal angle correction: a systematic review and meta-analysis of randomized controlled trials

Yu-Ning Peng et al. J Orthop Surg Res. .

Abstract

Background: This systematic review and meta-analysis aimed to investigate the differences in hallux valgus angle (HVA), intermetatarsal angle (IMA), American Orthopedic Foot and Ankle Society (AOFAS) scores, and complication rates between chevron osteotomy and scarf osteotomy for correcting hallux valgus.

Methods: Two investigators independently searched for randomized controlled trials (RCTs) published from 2007 to 2018 on PubMed, Web of Science, and Cochrane Library databases. Next, chevron and scarf osteotomies were compared for their postoperative outcomes using HVA, IMA, and AOFAS scores and their complication rates. Meta-analysis was performed using Review Manager (version 5.3).

Results: Six RCTs-comprising 507 feet, of which 261 and 246 underwent chevron and scarf osteotomies, respectively-were included. The meta-analysis revealed that chevron osteotomy led to significantly smaller postoperative HVAs than scarf osteotomy (weighted mean difference [WMD] = -1.94, 95% CI = - 2.65 to - 1.29, P < .00001). However, the differences in postoperative IMA (WMD = - 0.44, 95% CI = - 1.10 to 0.22, P = .19), postoperative AOFAS scores (WMD = 0.75; 95% CI = - 5.32 to 6.82; P = .81), and complication rates (risk ratio = 1.22, 95% CI = 0.65-2.27, P = .53) between feet that underwent chevron and scarf osteotomies were nonsignificant.

Conclusions: Compared with scarf osteotomy, chevron osteotomy had significantly more favorable postoperative outcomes in terms of HVA correction, but not in terms of IMA, AOFAS scores, or complication rates.

Level of evidence: Level I, systemic review and meta-analysis.

Keywords: Chevron osteotomy; Complication; Hallux valgus; Hallux valgus angle; Intermetatarsal angle; Scarf osteotomy.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow chart of the literature search and selection process
Fig. 2
Fig. 2
Graph of risk of bias
Fig. 3
Fig. 3
Summary of risk of bias
Fig. 4
Fig. 4
Forest plot analysis of postoperative HVAs for the chevron and scarf osteotomy groups
Fig. 5
Fig. 5
Forest plot analysis of postoperative IMAs for the chevron and scarf osteotomy groups
Fig. 6
Fig. 6
Forest plot analyses of postoperative AOFAS scores for the chevron and scarf osteotomy groups
Fig. 7
Fig. 7
Forest plot analysis of postoperative complication rates for the chevron and scarf osteotomy groups
See this image and copyright information in PMC

References

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