Scarf vs minimally invasive 5 metatarsal osteotomy for the reduction of tailors bunions: A systematic review and meta-analysis

Abstract

Scarf osteotomy is established for correcting bunionette deformities. Popularity of MIS has challenged whether percutaneous osteotomy has comparable outcomes with fewer complications although head-to-head trials are lacking.All studies demonstrating buniontte reduction via scarf or percutaneous osteotomy between 2000-2023 were collated. Systematic review and meta-analysis of clinical and patient reported outcomes was performed. Methodological quality assessment and risk of bias was reviewed. Mean statistical analyses of outcomes and complications were calculated. 11 small cases series met inclusion: 115 scarf osteotomy vs 170 MIS surgical episodes. All studies demonstrated statistically significant and comparable outcomes. Complications varied between procedures. All studies demonstrated high risk of bias. Both techniques adequately correct deformity delivering high patient satisfaction. Complication rates are similar although they manifest differently. The results of this study can be used to aid patient selection when considering open scarf or percutaneous 5 metatarsal osteotomy.