{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T14:07:46Z","timestamp":1778940466740,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Orthopaedics"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>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\u2009mm 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>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\u2019 symptoms. Analyses were performed using IBM SPSS version 25.0<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 134\u2009feet 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 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.05). In terms of first metatarsal shortening, both META and Lapidus were significantly less than that of scarf (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.05). In our study, both META and Lapidus demonstrated the least first metatarsal shortening. A significant first metatarsal shortening of more than 4\u2009mm was observed in 7 cases who underwent scarf, whereas none were observed in the META and Lapidus groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Level of Evidence<\/jats:bold>\n                      : Level III, retrospective cohort study.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/24730114261445962","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T14:40:36Z","timestamp":1778769636000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Radiographic Outcomes and Risk of First Metatarsal Shortening Between different Hallux Valgus Surgeries: An Asian Perspective"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6887-1984","authenticated-orcid":false,"given":"Bryan","family":"Hon Keng Pui","sequence":"first","affiliation":[{"name":"Sengkang General Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teddy","family":"Cheong Yao Wen","sequence":"additional","affiliation":[{"name":"Changi General Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Png","family":"Wenxian","sequence":"additional","affiliation":[{"name":"Sengkang General Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inderjeet Singh","family":"Rikhraj","sequence":"additional","affiliation":[{"name":"Sengkang General Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Cher Wei Liang","sequence":"additional","affiliation":[{"name":"Sengkang General Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-023-00661-9"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/btf.0000000000000102"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.24.01326"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-024-05521-0"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2019.10.011"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2014.02.008"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.00975"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1530\/EOR-22-0043"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2021.11.005"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-019-2973-6"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/2473011424s00498"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04972-5"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100719874360"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/1757-1146-3-2"},{"issue":"3","key":"e_1_3_2_16_2","first-page":"559","article-title":"Scarf osteotomy for correction of hallux valgus. 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