To explore the application efficacy and safety of different osteotomy schemes in the repair and treatment of moderate to severe hallux valgus deformities. A sum of 117 patients with moderate to severe acute hallux valgus who underwent treatment at our hospital from April 2020 to April 2022 were selected. The envelope method was used to group the patients. The control group (n = 58) underwent double-plane osteotomy of the first metatarsal bone, while the observation group (n = 59) underwent Scarf osteotomy. The clinical efficacy of the 2 groups was compared, the differences in imaging results between the 2 groups at 6 months after surgery were analyzed, and the occurrence of complications during the follow-up period was observed. The excellent rate of the study group patients was 83.05% (49/59), which was compared to that of the control group (81.03%, 47/58) (P >
.05). In comparison to the control group patients, the pain, force line, and joint function scores of the study group were compared before surgery and at 3 months after surgery (P >
.05). Compared to before surgery, the pain, force line, joint function scores, The American Orthopaedic Foot & Ankle Society (AOFAS) total score, and Berg Balance Scale (BBS) score of the patients in both groups increased at 3 months after surgery. Additionally, the AOFAS total score and BBS score of the study group patients were higher than those of the control group patients (P <
.05). The visual analog scale (VAS) scores of the patients in the 2 groups were compared before surgery (P >
.05). The VAS scores of the study group patients were higher than those of the control group patients at 1, 2, and 3 months after surgery (P <
.05). The study group patients were compared with the control group patients in terms of the hallux valgus angle, the lengths of the first and second metatarsals, the angle between the first and second metatarsals, the angle of the metatarsophalangeal joint surface, the position of the sesamoids, and the shortening length of the first metatarsal (P >
.05). The Scarf osteotomy has shown advantages in postoperative gait balance and functional scoring. Therefore, when choosing an osteotomy plan, the Scarf osteotomy can be given priority to enhance the patient's balance ability and enhance their postoperative quality of life.