Comparison of Chevron and Scarf techniques for Hallux Valgus correction

Abstract

Hallux Valgus is one of the most common pathologies today. There are many surgical techniques for their correction. The objective of this work was to carry out a literature review of two of the most frequently used techniques, The Chevron osteotomy, along with its modification, and the Scarf osteotomy, to determine which one obtains better results. The Chevron technique is performed by a V-shaped cut of 60° horizontal centered on the head of the first metatarsal, then moves the metatarsal head laterally with the purpose of narrowing the forefoot, reducing the intermetatarsal angle (IMA). The modification of this technique consists of incorporating an extended plantar limb, in order to increase the correction of this angle. The Scarf osteotomy has a horizontal “Z” shape on the axis of the first metatarsal. The most distal fragment moves to the side, also decreasing the AIM. Following this review, a heterogeneity of results was observed. More and better studies are required to determine the dominance of one technique over another. Most of the studies reviewed did not obtain significant differences between the two techniques. There is a slight preference of Chevron, based on IMA correction and hallux valgus angle (HVA), the simplicity of the technique, the osteosynthesis and the cost-effectiveness. However, most authors agree that satisfactory results depend on the experience of the surgeon.