Clinical Efficacy of the Reversed 'L'-Shaped Osteotomy Combined with Lateral Soft Tissue Release in the Treatment of Moderate to Severe Hallux Valgus: A Comparative Study with Scarf Osteotomy.

Abstract

The purpose of this study was to evaluate the clinical efficacy of the "Reversed L" osteotomy combined with lateral soft tissue release for moderate to severe hallux valgus. A retrospective analysis was performed on the clinical and radiographic data in patients diagnosed with moderate to severe hallux valgus who underwent surgical treatment between January 2023 and January 2025. Patients were categorized into two groups based upon technique: the ReveL group (ReveL group: n=244 feet) and the Scarf group (Scarf group: n=234 feet). Clinical and radiological parameters were compared between two groups pre and post operatively. The clinical and radiological outcomes of the two groups were rigorously studied assessing both diagnostic accuracy and treatment efficacy. All patients successfully underwent surgery and completed the follow-up. Compared with the Scarf group, the ReveL group exhibited a significantly shorter operation time (70±13 vs. 90±21 minutes, P=0.038). Statistically significant differences were noted in all preoperative and postoperative clinical and imaging parameters within each group (all P<0.001). Postoperatively, statistically significant differences were observed between the two groups in hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), and visual analog scale (VAS)(P<0.05). Specifically, the postoperative HVA and DMAA values in the ReveL group were significantly lower than those in the Scarf group (P <0.05), in addition, the postoperative VAS score in the ReveL group was significantly lower than in the Scarf group (P<0.01). Compared to Scarf osteotomy, ReveL osteotomy demonstrates superior correction of metatarsal rotational deformity and provides more significant improvement in moderate to severe hallux valgus. Therefore, it serves as an effective and reliable surgical option for correcting deformities in this patient population. not applicable LEVEL OF EVIDENCE: III (Retrospective Comparative Study).