To evaluate the therapeutic effect of Chevron osteotomy and Scarf osteotomy in patients with moderate hallux valgus and their impact on biomechanics.

A total of 90 patients with moderate hallux valgus admitted to the Fourth People's Hospital of Guiyang from January 2017 to January 2021 were divided into a Chevron osteotomy group and a Scarf osteotomy group, with 45 cases in each group. The Chevron osteotomy group was treated by Chevron osteotomy, and the Scarf osteotomy group was treated by Scarf osteotomy. The two groups were compared for imaging-related indicators, biomechanics, pain, symptom improvement, clinical efficacy, and recurrence.

In terms of imaging-related indicators, postoperative hallux valgus angle (HVA), intermetatarsal angle (IMA) between the first and second metatarsals, the first distal metatarsal articular angle (DMAA), and tibial sesamoid position (TSP) decreased significantly in both groups compared with preoperative values; these indicators were significantly lower in the Scarf osteotomy group than in the Chevron osteotomy group (P＜0.05 each). The postoperative length of the first metatarsal bones decreased significantly in both groups, and the reduction in the Scarf osteotomy group was more significant than that of the Chevron osteotomy group (P＜0.05). In terms of biomechanics, the pressures in the middle of the toe pouch, the medial metatarsal head, and the dorsal side of the metatarsal head (walking, standing, active plantar flexion, and passive plantar flexion) were significantly reduced postoperatively in both groups; these indices in the Scarf osteotomy group were significantly lower than those of the Chevron osteotomy group (P＜0.05 each). In terms of pain and symptom improvement, the visual analogue score (VAS) during postoperative activities decreased significantly in both groups, and American orthopedic foot and ankle society (AOFAS) scores of the first metatarsal bone, metatarsophalangeal joint, and interphalangeal joint were significantly increased; the changes in the Scarf osteotomy group were more significant than those of the Chevron osteotomy group (P＜0.05). In terms of clinical efficacy and recurrence rate, the Scarf osteotomy group was associated with a higher rate of marked improvement and a lower recurrence rate (P＜0.05).

Compared with Chevron osteotomy, Scarf osteotomy is more effective in correcting moderate hallux valgus, can change the abnormal biomechanics without shortening the length of the first metatarsal, and has a lower recurrence rate.