Comparison of results of treatment of patients with hallux valgus using a various combined bone and tendon techniques

Abstract

Background. The aim of the present study was to compare the methods of adductor hallucis muscle fixation in treatment of patients with hallux valgus followed by a modified scarf procedure. Methods. The data on 40 patients (60 feet) with hallux valgus that were operated on between 2011 and 2015 in St. Petersburg hospital 2, using modified scarf procedure combined with adductor hallucis muscle transposition was analysed. Functional assessment (AOFAS score) and X-ray examination were performed preoperatively, 3, 6 and 12 months after the procedure. Comparative analysis between groups with anchor fixation and bone suture has been carried out. Results. We did not find any significant difference between these two groups in mean AOFAS score, which improved to 86,5 ± 7,1 in bone suture group and 84,7 ± 5,9 in anchor group 12 months after the surgery. 12 months after surgery in mean intermetatarsal angle was 8,5 ± 0,7° in group 1 and 8,7 ± 0,7° in group 2 (p > 0,05). There was no significant difference between radiographic parameters in both groups, except mean metatarsophalangeal angle 12 months after the operation (13,3 ± 1,1° and 12,7 ± 1,0° (р < 0,05), which was better in anchor group. Nevertheless the difference 0,6° was out of practical importance and did not exceed the computational error. Conclusion. According to data obtained, modified scarf procedure combined with adductor hallucis muscle transposition with anchor fixation compared to bone suture does not improve functional and x-ray results though facilitating this stage of the operation. Refs 18. Figs 5. Тables 4.