ArticleFoot & ankle orthopaedics2026
Comparison of Radiographic Outcomes and Risk of First Metatarsal Shortening Between different Hallux Valgus Surgeries: An Asian Perspective.
Article in Foot & ankle orthopaedics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The prevalence of hallux valgus is up to 22% in Asia, making it the second-highest in the world. Iatrogenic transfer metatarsalgia is a known complication of hallux valgus correction from excessive shortening of the first metatarsal. Most studies show that first metatarsal shortening should be less than 4.0 mm to avoid such complications. This study aims to compare the risk of first metatarsal shortening, radiologic, and clinical outcomes among surgical procedures used to treat symptomatic hallux valgus. Methods: A retrospective study was conducted at a single tertiary hospital using data on patients who underwent minimally invasive metaphyseal extra-articular transverse and Akin osteotomy (META), Lapidus, and scarf procedures. Radiologic outcomes collected include the hallux valgus angle (HVA), intermetatarsal angle (IMA), and first metatarsal shortening measured using the Maestro method. The visual analog scale (VAS) was used to evaluate improvement in patients' symptoms. Analyses were performed using IBM SPSS version 25.0. Results: A total of 134 feet were included in this study, with 66 META, 37 Lapidus, and 31 scarf procedures performed. All 3 techniques demonstrated significant improvements in VAS, HVA, and IMA compared with their preoperative measurements ( Conclusion: All 3 surgical techniques have been shown to provide adequate correction of hallux valgus deformity. Based on our study, scarf has the highest risk of radiologic metatarsal shortening among the 3 procedures, which may potentially lead to transfer metatarsalgia. Care should be taken during the scarf procedure to minimize shortening of the first metatarsal.
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