[Chevron osteotomy versus Scarf osteotomy for the efficacy of radiographic and clinical in moderate and severe hallux valgus:a systematic review].

ABSTRACT

OBJECTIVE: To evaluate efficacy of radiographic and clinical of Chevron osteotomy versus Scarf osteotomy for hallux valgus at moderate and severe degree. METHODS: Randomized controlled trial (RCT) about Chevron and Scarf osteotomy for hallux valgus, in PubMed, Embase, Cochrane Library, CBM, CNKI, Wanfang Data were searched by computer from establishing database to June 2018. According to inclusion and exclusion criteria, two researchers independently screened the literatures, evaluated risk of bias and extracted related observation index, RevMan 5.3.5 software was used to perform Meta-analysis. Postoperative hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), AOFAS score, complications and patients' satisfaction degree between Chevron and Scarf osteotomy. RESULTS: Six RCT literatures were included, involving 507 patients, 92.5% patients were at moderate and severe degree, and 261 patients were performed by Chevron osteotomy and 246 patients were performed by Scarf osteotomy. Meta analysis results showed that Chevron osteotomy was better than Scarf osteotomy in correcting HVA [MD=-1.95, 95%CI(-2.64, -1.27), P<0.000 01]. While there were no statistical differences in IMA [MD=-0.42, 95%CI(-1.04, 0.21), P=0.19], DMAA[MD=0.78, 95%CI(-0.72, 2.29), P=0.31], AOFAS score [MD=2.47, 95%CI(-2.38, 7.33), P=0.32], complications [RR=1.09, 95%CI(0.54, 2.20), P=0.82], and patients' satisfaction degree [RR=1.00, 95%CI(0.96, 1.05), P=0.92]. CONCLUSIONS: Chevron osteotomy, which has advantages in simple operation, shorten metatarsal bone, less trauma, was better in correcting HVA of hallux valgus at moderate and severe degree, and had similar effects in IMA, DMAA, AOFAS score, complications and patients' satisfactory degree.