Percutaneous Chevron/Akin (Peca) Versus Open Scarf/Akin (Sa) Osteotomies Treatment in Hallux Valgus: A Systematic Review and Meta-Analysis of 137 Feet

CATEGORY: Bunion INTRODUCTION/PURPOSE: The surgical treatment of hallux valgus presents several techniques described in the literature. Recently the percutaneous technique appeared as a less invasive option in the correction of the deformity and more and more used by the surgeons. METHODS: The meta-analysis was performed through studies found from the systematic review of articles included in electronic databases (Medline, Scopus, Embase and the Cochrane Library) until June 2018 (Systematic Review Registry PROSPERO: CRD42018096613). The pooled analysis was synthesized from clinical outcomes such as visual analogue scale of pain and AOFAS score, radiographic outcomes and evaluation of complications, with 95% confidence interval. The pooled data were weighted using the fixed model effect. RESULTS: Two studies, including 137 feet with hallux valgus diagnosis were added in the analysis, comparing open surgery using the Scarf and Akin (SA) technique versus the percutaneous Chevron and Akin (PECA). In the synthesis of the result, pain in the perioperative period was lower in the PECA group, with a reduction of 1.96 points in the fixed effect model (95% CI = -2.28 to - 1.65, p = 0.53, i2 = 0%, t2 = 0), without presenting differences between techniques in the radiographic result, nor in the risk of complications. The PECA technique demonstrated longer radioscopy time when compared to SA. CONCLUSION: The use of the percutaneous method (PECA) to correct hallux valgus when compared to the open technique (SA) demonstrated less pain in the perioperative period, similar potential of radiographic correction and an equal risk of complications, with a longer radioscopy time.