To explore the clinical study and efficacy of three dimentional (3D) printed osteotomy plate combined with Scarf osteotomy in the treatment of moderate to severe hallux valgus deformity.

Twenty-four patients (30 feet) with moderate to severe valgus admitted to the Department of Joint Surgery, 940th Hospital of the Joint Logistics Support Force from October 2018 to December 2023 were divided into two groups: the observation group adopted Scarf osteotomy assisted by 3D printing osteotomy guide plate and the control group adopted conventional Scarf osteotomy, 12 patients with 15 feet in each group. In the observation group, the patients were from 43 to 49 years old, the preoperative hallux valgus angle (HVA) was 30° to 46°, and intermetatarsal angle (IMA) was 11° to 25°. In the control group, the patients were from 44 to 49 years old, the preoperative HVA was 30° to 45°, and IMA was11° to 23°. The following parameters were compared: operative time, intraoperative blood loss, hospital stay, postoperative complications, visual analog scale (VAS) pain score at one week after surgery, American Orthopaedic Foot & Ankle Society (AOFAS) functional scores, and radiographic parameters immediate after surgery and at final follow-up, including HVA, IMA, distal metatarsal articular angle (DMAA), relative length of the first metatarsal (RLFM). Statistical analysis included repeated-measures ANOVA for multi-timepoint quantitative data, t tests for continuous variables, and chi square test for categorical variables.

All the incisions were healed by first intention without complications. No significant differences were observed between groups in follow-up duration (t=0.820), intraoperative blood loss (t=1.430), length of hospital stay (t=0.990), or VAS scores one week after surgery (t=1.099) (all P>0.05). The observation group exhibited significantly shorter operative time than the control group (t=-1.430, P<0.001). The immediate data of HVA, IMA, DMAA, and AOFAS after surgery and the data at final follow-up compared to the data before surgery in both the observation and control groups showed statistically significant differences (observation group: F=225.1, 54.93, 139.3, 1103, control group: F=165.5, 33.65, 88.3, 818.5, all P<0.001). Between-group comparisons of the HVA, IMA, DMAA, and AOFAS scores immediately postoperatively and at final follow-up revealed statistically significant differences (observation vs. control group: t=-2.733, -2.662, -3.138, 2.083, -2.890, -3.081, -2.727, 4.108, all P<0.05). No statistically significant difference was observed in RLFM between the two groups at immediate time point after surgery or at final follow-up (t=-0.419, -0.455, both P>0.05).

The 3D-printed osteotomy guide-assisted Scarf osteotomy improves surgical precision, enhances alignment correction, and optimizes functional recovery in moderate-to-severe hallux valgus.