Mid-term results of Scarf osteotomy in hallux valgus

Abstract

We performed a retrospective study on 178 Scarf osteotomies with a mean follow-up of 44.9 months (range 15-83 months). Clinical rating was based on the forefoot score of the American Orthopaedic Foot and Ankle Society (AOFAS). Weight bearing X-rays were used to perform angular measurements and assess the first metatarsophalangeal joint (MTP 1). At follow-up the mean AOFAS score had improved significantly (p<0.001), but only 55% of the feet showed a perfect realignment of the first ray. Patients with a hallux valgus angle exceeding 30°and preexisting degenerative changes at the MTP 1 joint displayed inferior clinical results (p<0.05). Nearly 20% of the patients suffered from pain at the MTP 1 joint. This was clearly attributed to an onset or worsening of distinct radiographic signs of arthritis (p<0.05) resulting in painfully decreased joint motion. Comparing radiographic appearance three months postoperatively and at follow-up, we found that radiographic criteria (hallux valgus, first intermetatarsal angle, hallux valgus interphalangeus, MTP 1 joint congruency, arthritic lesions at MTP 1) worsened with time.

The Scarf Osteotomy with Minimally Invasive Lateral Release for Treatment of Hallux Valgus Deformity

“…P revious studies have shown that the Scarf osteotomy achieves predictable results 3,[5][6][7][8]23,24 . However, none of those studies presented long-term, intermediate-term, and immediate postoperative results of the same patient cohort or reported the factors influencing long-term outcomes.…”

“…Surgical treatment of hallux valgus deformity includes an osteotomy of the first metatarsal bone (MT-I) and a softtissue procedure. The Scarf osteotomy, a midshaft osteotomy of the MT-I that is often performed in combination with a closingwedge osteotomy of the proximal phalanx of the big toe (Akin osteotomy 1 ), is one of the established methods [2][3][4][5][6][7][8][9][10] . The Scarf osteotomy is characterized by its "Z" shape (Figs.…”

Long-term results of the retrocapital metatarsal percutaneous osteotomy for hallux valgus

“…Over 130 different surgical techniques [1][2][3][4] to correct hallux valgus deformity have been proposed, although choosing the most appropriate treatment option continues to generate controversy [5][6][7][8][9][10][11]. The current trend is directed toward percutaneous procedures with the potential benefits of minimally invasive surgery [2], e.g.…”

Proximal opening wedge metatarsal osteotomy for correction of moderate to severe hallux valgus deformity using a locking plate

“…This angle remained constant from the time of union to the last follow-up. The mean pre-operative HVA was 39 (range 21-52) degrees, and the mean postoperative HVA was 11.8 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) degrees. The mean HVA at the last followup was 12.7 (range 6-30) degrees.…”

“…Different types of proximal metatarsal osteotomies have been used over the last decades including proximal crescentic osteotomy [7], proximal chevron osteotomy [8,9], scarf osteotomy [10,11], Ludloff osteotomy [12], Mau osteotomy [13], modified Mau [14], lateral closing wedge basal osteotomy [15] and medial opening wedge basal osteotomy [16].…”