PMID- 36102216 OWN - NLM STAT- MEDLINE DCOM- 20221005 LR - 20221012 IS - 1757-7861 (Electronic) IS - 1757-7853 (Print) IS - 1757-7853 (Linking) VI - 14 IP - 10 DP - 2022 Oct TI - A Better Treatment for Moderate to Severe Hallux Valgus: Scarf + Akin Osteotomy Combined with Lateral Soft Tissue Release in a Single Medial Incision. PG - 2633-2640 LID - 10.1111/os.13479 [doi] AB - OBJECTIVE: Traditional lateral soft tissue release (LSTR) was conducted by an additional dorsal first web incision, as the malformed thick scar and neuritis were common after surgery. A new method of lateral soft tissue release in a single medial incision via dorsal flap over the first metatarsal (LSTR-SMI-DFFM) should be recommended. The objective is to investigate the clinical effectiveness and safety of scarf + Akin osteotomy (SAO) combined with lateral soft tissue release in a single medial incision via dorsal flap over the first metatarsal (LSTR-SMI-DFFM) for moderate to severe hallux valgus. METHODS: Patients who were performed surgery for hallux valgus from April 2014 to June 2020 were retrospectively reviewed. The visual analog scale (VAS) was recorded before surgery and during follow-up, as well as the forefoot score of the American Orthopaedic Foot and Ankle Society (AOFAS). Patient satisfaction was evaluated at the follow-up time. The preoperative and follow-up weightbearing X-ray were conducted in all patients. The radiological parameters of hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) were measured. Tibial sesamoid position (TSP) was also recorded according to seven-part grading system. The quantitative data were performed as mean +/- standard deviation or median +/- interquartile range. Student's t test was performed in HVA, IMA, and DMAA. The TSP, VAS, and AOFAS were statistical analyzed by Mann-Whitney U test. p value of <0.05 was considered significant. RESULTS: There were 123 feet conducted surgery in 96 patients. The AOFAS score improved a lot which was preoperative 39 to 100 at the follow-up time and VAS was 4 to 0 (p < 0.001). A total of 63 (51.2%) patients were very satisfied, 47 (38.2%) were satisfied, five (4.1%) were undecided and eight (6.5%) were not satisfied. The HVA, IMA, DMAA, and TSP were all decreased after surgery and were statistically significant (p < 0.001). CONCLUSION: The SAO combined with a LSTR-SMI-DFFM for moderate to severe hallux valgus is effective and safe with pretty good clinical and radiographic results, as well as minimal complications. The corrections of AOFAS and VAS conformed to the minimum clinically important difference (MCID). CI - (c) 2022 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd. FAU - Xie, Wenyong AU - Xie W AD - Department of Orthopaedics and Trauma, Peking University People's Hospital, Beijing, China. AD - Beijing Jishuitan Hospital, Beijing, China. FAU - Lu, Hao AU - Lu H AD - Department of Orthopaedics and Trauma, Peking University People's Hospital, Beijing, China. FAU - Zhan, Sizheng AU - Zhan S AUID- ORCID: 0000-0001-9852-2963 AD - Department of Orthopaedics and Trauma, Peking University People's Hospital, Beijing, China. FAU - Li, Guicheng AU - Li G AD - Department of Orthopaedics and Trauma, Peking University People's Hospital, Beijing, China. FAU - Yuan, Yusong AU - Yuan Y AD - Department of Orthopaedics and Trauma, Peking University People's Hospital, Beijing, China. FAU - Xu, Hailin AU - Xu H AUID- ORCID: 0000-0003-1829-3852 AD - Department of Orthopaedics and Trauma, Peking University People's Hospital, Beijing, China. LA - eng GR - 2019YFB1311403/The National Key Research and Development Program of China/ GR - Z181100001718159/The Beijing Municipal Science and Technology Project/ GR - 2020-2-4086/Capital's Funds for Health Improvement and Research/ GR - Key Laboratory of Trauma and Neural Regeneration (Peking University), Ministry of Education/ PT - Journal Article DEP - 20220914 PL - Australia TA - Orthop Surg JT - Orthopaedic surgery JID - 101501666 SB - IM MH - *Hallux Valgus/diagnostic imaging/surgery MH - Humans MH - *Metatarsal Bones/surgery MH - *Metatarsophalangeal Joint MH - Osteotomy/methods MH - Retrospective Studies MH - *Surgical Wound MH - Treatment Outcome PMC - PMC9531105 OTO - NOTNLM OT - Akin osteotomy OT - hallux valgus OT - lateral soft tissue release OT - scarf osteotomy OT - single medial incision EDAT- 2022/09/15 06:00 MHDA- 2022/10/06 06:00 PMCR- 2022/09/14 CRDT- 2022/09/14 05:32 PHST- 2022/08/03 00:00 [revised] PHST- 2021/09/14 00:00 [received] PHST- 2022/08/06 00:00 [accepted] PHST- 2022/09/15 06:00 [pubmed] PHST- 2022/10/06 06:00 [medline] PHST- 2022/09/14 05:32 [entrez] PHST- 2022/09/14 00:00 [pmc-release] AID - OS13479 [pii] AID - 10.1111/os.13479 [doi] PST - ppublish SO - Orthop Surg. 2022 Oct;14(10):2633-2640. doi: 10.1111/os.13479. Epub 2022 Sep 14.