Comparison of Clinical Outcomes of Scarf and Chevron Osteotomies and the McBride Procedure in the Treatment of Hallux Valgus Deformity

Document Type : RESEARCH PAPER


1 Department of Orthopedic, Emam Teaching Hospital, Ahvaz University of Medical Science, Ahvaz, Iran

2 Department of Orthopedic, Golestan Teaching Hospital, Ahvaz University of Medical Science, Ahvaz, Iran


Hallux valgus deformity is a common chronic problem in middle age and elderly. Different surgical
procedures have been introduced so far with their proposed indications for each. This study aimed to compare three
current procedures namely Chevron osteotomy, Scarf osteotomy and McBride technique.
In this study, 44 patients were included from 2010 to 2013. All patients had been undergone one of the
three current procedures including Chevron, Scarf or McBride techniques. Preoperative and follow-up radiographies
were evaluated in terms of hallux valgus and intermetatarsal angles. Foot Ankle Disability Index was filled to assess
the functional. A Visual Analogue Scale evaluated pain. Also, satisfaction, aesthetic and the rate of recurrence were
Functional score, aesthetic and satisfaction level were higher in Scarf technique rather than Chevron and
McBride techniques. Also, pain score and recurrence rate were lower in Scarf Technique rather the other two techniques.
With respect to better results with Scarf osteotomy in this study, we recommend Scarf osteotomy as
a first choice for treatment of moderate hallux valgus deformity.


  1. Vanore JV, Christensen JC, Kravitz SR, Schuberth JM, Thomas JL, Weil LS, et al. Diagnosis and treatment of first metatarsophalangeal joint disorders. Section 1: Hallux valgus.J Foot Ankle Surg. 2003;42(3):112-23.

  2. Roddy E, Zhang W, Doherty M. Prevalence and associations of hallux valgus in a primary care population.Arthritis Rheum. 2008;59(6):857-62.

  3. Hannan MT, Menz HB, Jordan JM, Cupples LA, Cheng CH, Hsu YH. High heritability of hallux valgus and lesser toe deformities in adult men and women.Arthritis Care Res (Hoboken). 2013;65(9):1515-21.

  4. Schneider W, Csepan R, Knahr K. Reproducibility of the radiographic metatarsophalangealangle in halluxsurgery. J Bone Joint Surg Am. 2003; 85(3):494-9.

  5. Robinson AH, Limbers JP. Modern concepts in the treatment of hallux valgus. J Bone Joint Surg Br. 2005; 87(8):1038-45.

  6. Austin DW, Leventen EO. A newosteotomy for halluxvalgus: a horizontally directed “V” displacementosteotomy of the metatarsalhead for halluxvalgus and primusvarus. Clin Orthop Relat Res. 1981;157:25-30.

  7. Newman AS, Negrine JP, Zecovic M, Stanford P, Walsh WR. A biomechanical comparison of the Z step-cut and basilar crescentic osteotomies of the first metatarsal. Foot Ankle Int. 2000;21(7):584-7.

  8. Mazaheri M, Salavati M, Negahban H, Sohani SM, Taghizadeh F, Feizi A, et al. Reliability and validity of the Persian version of Foot and Ankle Ability Measure (FAAM) to measure functional limitations in patients with foot and ankle disorders.Osteoarthritis Cartilage. 2010;18(6):755-9.

  9. De Lavigne C, Rasmont Q, Hoang B. Percutaneous double metatarsal osteotomy for correction of severe hallux valgus deformity. Acta Orthop Belg. 2011;77(4):516-21.

  10. Kayali C, Ozturk H, Agus H, Altay T, Hancerli O. The effectiveness of distal soft tissue procedures in hallux valgus. J OrthopTraumatol. 2008;9(3):117-21.

  11. Gebuhr P, Soelberg M, Larsen TK, Niclasen BV, Laursen NO. McBride’s operation for hallux valgus. A 2-11-year follow-up of 46 cases. Acta Orthop Scand. 1992;63(2):189-91.

  12. Johnson JE, Clanton TO, Baxter DE, Gottlieb MS. Comparison of Chevron osteotomy and modified McBride bunionectomy for correction of mild to moderate hallux valgus deformity. Foot Ankle. 1991;12(2):61-8.

  13. Trnka HJ, Zembsch A, Easley ME, Salzer M, Ritschl P, Myerson MS. The chevron osteotomy for correction of hallux valgus. Comparison of findings after two and five years of follow-up. J Bone Joint Surg Am. 2000;82(10):1373-8.

  14. Nery C, Barroco R, Réssio C. Biplanar chevron osteotomy. Foot Ankle Int. 2002;23(9):792-8.

  15. Deenik AR1, Pilot P, Brandt SE, van Mameren H, Geesink RG, Draijer WF. Scarf versus chevron osteotomy in hallux valgus: a randomized controlled trial in 96 patients. Foot Ankle Int. 2007;28(5):537-41.