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Foot Ankle Int. 2017 Aug;38(8):838-846. doi: 10.1177/1071100717704941. Epub 2017 May 5.

Hallux Valgus Correction Comparing Percutaneous Chevron/Akin (PECA) and Open Scarf/Akin Osteotomies.

Author information

1
2 Department of Orthopaedic Surgery, Ilsan Paik Hospital, South Korea.
2
3 Cappagh National Orthopaedic Hospital, Dublin, Ireland.
3
4 Kolling Institute of Bone and Joint Research, University of Sydney, St Leonards, New South Wales, Australia.
4
5 Sydney Orthopaedic Specialist, Randwick, Australia.
5
6 North Sydney Orthopaedic and Sports Medicine Centre, St Leonards, New South Wales, Australia.
6
1 Orthopaedic and Arthritis Specialist Centre, Chatswood, Sydney, Australia.

Abstract

BACKGROUND:

Minimally invasive surgery is being used increasingly, including for hallux valgus surgery. Despite the growing interest in minimally invasive procedures, there have been few publications on percutaneous chevron/akin (PECA) procedures, and no studies have been published comparing PECA to open scarf/akin osteotomies (SA).

METHODS:

This was a prospective, randomized study of 50 patients undergoing operative correction of hallux valgus using one of 2 techniques (PECA vs open SA). Data were collected preoperatively and on 1 day, 2 weeks, 6 weeks, and 6 months postoperatively. Outcome measures include the American Orthopaedic Foot & Ankle Society Hallux-Metatarsophalangeal-Interphalangeal (AOFAS-HMI) Score, visual analog pain score, hallux valgus angle (HVA), and 1-2 intermetatarsal angle (IMA). Twenty-five patients underwent PECA procedures and 25 patients received SA procedures.

RESULTS:

Both groups showed significantly improved AOFAS-HMI scores after surgery (PECA group: 61.8 to 88.9, SA group: 57.3 to 84.1, P = .560) with comparable final scores. HVA and IMA also presented similar outcomes at final follow-up ( P = .520 and P = .270, respectively). However, the PECA group showed significantly lower pain level (VAS) in the early postoperative phase (postoperative day 1 to postoperative week 6, P < .001 and P = .004, respectively). No serious complications were observed in either group.

CONCLUSION:

Both groups showed comparable good to excellent clinical and radiologic outcomes at final follow-up. However, the PECA group had significantly less pain in the first 6 weeks following surgery. Level of Evidence Level II, prospective comparative study.

KEYWORDS:

akin; chevron; hallux valgus; minimally invasive; percutaneous; scarf osteotomy

PMID:
28476096
DOI:
10.1177/1071100717704941
[Indexed for MEDLINE]

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