Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Radiographic Risk Factors of Recurrent Hallux Valgus Deformity after Modified Scarf and Akin Osteotomy

변형 Scarf 및 Akin 절골술 후 무지외반변형 재발의 방사선학적 위험인자 연구

  • Suh, Jae Wan (Department of Orthopedic Surgery, Dankook University College of Medicine) ;
  • Kim, Sung Hyun (Department of Orthopedic Surgery, Armed Forces Capital Hospital) ;
  • Park, Hyun-Woo (Department of Orthopedic Surgery, Dankook University College of Medicine)
  • 서재완 (단국대학교 의과대학 정형외과학교실) ;
  • 김성현 (국군수도병원 정형외과) ;
  • 박현우 (단국대학교 의과대학 정형외과학교실)
  • Received : 2019.10.29
  • Accepted : 2019.12.02
  • Published : 2019.12.15
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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.

Keywords

References

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