Application of Distal Chevron Biplanar Osteotomy Combined with Scarf or Proximal Lapidus Osteotomy in the Surgical Management of Moderate-to-Severe Hallux Valgus: A Retrospective Study

Objective This paper aims to assess the clinical effectiveness of combining distal first metatarsal biplanar Chevron osteotomy with either midshaft Scarf or proximal Lapidus osteotomy in treating moderate-to-severe hallux valgus.Methods This retrospective study included patients with moderate-to-severe hallux valgus treated with Chevron + Scarf or Chevron + Lapidus osteotomy and followed for at least 6 months. Outcomes included VAS, HVA, IMA, DMAA, AOFAS score, SF-36, osteotomy healing time, full weight-bearing time, and complications.Results Eighty-eight patients were included: 49 in the Chevron + Scarf group and 39 in the Chevron + Lapidus group. The Chevron + Scarf group had lower VAS scores at 1 week and 1 month postoperatively (P < 0.05), whereas the Chevron + Lapidus group achieved lower HVA and IMA at 3 and 6 months (P < 0.05). Healing time and time to full weight-bearing were shorter in the Chevron + Scarf group (P < 0.05). Improvements in DMAA, AOFAS, and SF-36 scores and complication rates were comparable between groups (P > 0.05).Conclusion Both osteotomy strategies effectively correct moderate-to-severe hallux valgus. Each combination has relative advantages, and surgical choice should be tailored to the patient’s anatomical and functional needs.