J Korean Foot Ankle Soc.  2019 Dec;23(4):159-165. 10.14193/jkfas.2019.23.4.159.

Radiographic Risk Factors of Recurrent Hallux Valgus Deformity after Modified Scarf and Akin Osteotomy

Affiliations
  • 1Department of Orthopedic Surgery, Dankook University College of Medicine, Cheonan, Korea. m3artist@hanmail.net
  • 2Department of Orthopedic Surgery, Armed Forces Capital Hospital, Seongnam, Korea.

Abstract

PURPOSE
This study investigated the recurrence rate after performing hallux valgus correction using scarf and Akin osteotomy, and also identified the correlation and cut-off values of both the preoperative and postoperative radiographic parameters as risk factors for the recurrence of hallux valgus.
MATERIALS AND METHODS
We reviewed 87 hallux valgus patients (122 feet) who received scarf and Akin osteotomy from January 2007 to August 2015. The clinical outcomes were evaluated using the visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores. The radiological outcome measures included the hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) as determined on the serial weight bearing radiographs. Recurrence was defined as more than 20 degrees of HVA noted on the final follow-up radiograph. Those radiological factors associated with recurrence were evaluated and analyzed.
RESULTS
The mean follow-up duration was 20.6 months (12.0∼46.5 months) and the mean age was 44 years (13∼80 years). The VAS and AOFAS scores were significantly improved at the time of the final follow-up (7.0 to 2.0, p<0.001; 78.0 to 92.0, p<0.001; respectively). Significant corrections in the HVA, IMA, and DMAA were obtained (p<0.001). Eleven (9.0%: 11/122) cases experienced recurrent hallux valgus deformity. The postoperative IMA, DMAA and HVA showed significant moderate to strong correlation with HVA at the final follow-up (Pearson correlation coefficient: 0.44, 0.70, and 0.88, respectively; p<0.001). Postoperative HVA>16.7 degrees, postoperative DMAA>13.9 degrees, and postoperative IMA>8.2 degrees showed statistically significant correlation with radiological recurrence at the last follow-up, and the odds ratio of each variable was high in order.
CONCLUSION
Our radiographic results indicated that postoperative HVA>16.7 degrees, postoperative DMAA>13.9 degrees, and postoperative IMA>8.2 degrees can be risk factors for hallux valgus recurrence. These risk factors may be helpful for modifying surgical procedures and preventing the recurrence of hallux valgus.

Keyword

Human forefoot; Hallux valgus; Recurrence; Osteotomy

MeSH Terms

Ankle
Congenital Abnormalities*
Follow-Up Studies
Foot
Forefoot, Human
Hallux Valgus*
Hallux*
Humans
Metatarsal Bones
Odds Ratio
Osteotomy*
Outcome Assessment (Health Care)
Recurrence
Risk Factors*
Weight-Bearing
Full Text Links
  • JKFAS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2022 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr