## 3 Results
### Systematic Review
#### 3.5.2 AOFAS and VAS

Table 3: _Cont._  
\begin{table}
\begin{tabular}{c c c c c c c c c} \hline \hline  & **[PERSON] et al. ** & **[PERSON] et al. ** & **[PERSON] et al. ** & **[PERSON] et al. ** & **[PERSON] et al. ** & **[PERSON] et al. ** & **[PERSON] et al. ** & **[PERSON] et al. ** & **[PERSON] et al. ** & **[PERSON] et al. ** & **[PERSON] et al. ** \\  & **1986** [35] & **1990** [15] & **[PERSON] et al. ** & **1999** [8]** & **[PERSON] et al. ** & **2016** [30]** & **[PERSON] et al. ** & **2018** [27]** & **[PERSON] et al. ** \\ \hline \multirow{10}{*}{Transfer lesions} & \multirow{4}{*}{NA} & \multirow{4}{*}{13 (26.5\%, transfer)} & \multirow{4}{*}{12 (22.1\%, under)} & \multirow{4}{*}{2/22 (0.10\%, one} & \multirow{4}{*}{2/20 (0.00\%, one} & \multirow{4}{*}{2/20 (0.00\%, one} & \multirow{4}{*}{2/20 (0.00\%, one} & \multirow{4}{*}{2/20 (0.00\%, one} & \multirow{4}{*}{2/20 (0.00\%, one} & \multirow{4}{*}{2/20 (0.00\%, one} & \multirow{*}{*}{2/20 (0.00\%, one} & \multirow{*}{*}{2/20 (0.00\%, one} & \multirow{*}{*}{2/20 (0.00\%, one} & \multirow{*}{*}{2/20 (0.00\%, one} & \multirow{*}{*}{2/20 (0.00\%, one} & \multirow{*}{*}{2/20 (0.00\%, one} & \multirow{*}{*}{2/20 (0.00\%, one} & \multirow{*}{*}{2/20 (0.00\%, one} & \multirow{*}{*}{2/20 (0.00\%, one }& \multirow{*}{*}{2/20 (0. 3.5.3. Peak Pressure under the Head of the Osteotomized Metatarsal  
This outcome was reported only in 1 study [41]. The outcome was found to decrease from 338.1 to 225.4 kPa (33%, \(p<0.0001\)) following surgery; the pressure time integral under the head of the osteotomized metatarsal decreased as well from 82.4 kPa to 65.0 kPa\(\cdot\)s (21%, \(p<0.0001\)). 3.5.4. Infection Rate  
Infection rate was reported in five studies and ranged from 3.3-31.8% [27; 30; 38; 39; 40; 41]. All infections were successfully resolved after administration of antibiotics. Wound discharge rate was reported only in one study [39] and was computed at 23.8%. Similarly, necrosis rate was reported only in one study [39] and was 4.8% (one case of necrosis of the fifth toe related to the casting, resulting in the amputation of the toe). 3.5.5. Non-Union Rate  
Non-union rate was reported in four studies, ranging from 4.5 to 30.0%, and all of them were asymptomatic [30; 38; 39; 41]. 3.5.6. Swelling Rate  
Swelling rate was reported only in noe study [27], where 18 out of 32 feet were found to be swollen. Swelling rate was computed at 56.3%, and was persistently moderate, affecting the forefoot for more than 6 weeks without infection. It improved after some months with complete callus formation at the osteotomy levels and without further treatment. 3.5.7. Recurrence/Relapse Rate  
Recurrence/relapse rate was reported in four studies and ranged from 0.0 to 13.6% [29; 38; 40; 41]. Loss of screw fixation was reported only in 1 study [38], with one case being reported (4.5%, with an acceptable metatarsal alignment being maintained). Redo-surgery rate was reported in two studies, ranging from 9.1 to 9.4%. 3.5.8. Acute Charcot  
This adverse outcome was reported only by [PERSON] et al. (1999) [38]. Seven cases (31.8%) were reported and treated with serial total contact casting until resolution of the acute inflammatory process and bony consolidation was identified on radiographs. 3.5.9. Transfer Lesion Rate  
Transfer lesions rate was reported in six studies and ranged from 9.1 to 26.5% [29; 30; 38; 39; 40; 41]. 3.5.10. Overall Complication Rate  
Overall complication rate was reported in three studies and ranged from 44.9 to 68.2% [29; 38; 41]. 3.6. Meta-Analysis  
3.6.1. Healing Rate  
The overall healing rate resulted 91.9%, ranging from 74.9 to 97.8%. Due to the significantly high amount of heterogeneity among studies (I\({}^{2}\) = 80.0%; Q = 30.04), a mixed-effect model was implemented. With the meta-regression analysis, it was found that the age of the recruited populations tended to become older through the years in a significant way (coefficient = 0.2724 (SE = 0.1180), \(p=0.0209\)) (Table 4). The lowest ES was reported in the study by [PERSON] et al.