Rotational Scarf and Akin Osteotomy for Correction of Hallux Valgus Associated with Metatarsus Adductus

Larholt, Jonathan; Kilmartin, Timothy E.

doi:10.3113/fai.2010.0220

Cited by 52 publications

(39 citation statements)

References 33 publications

(51 reference statements)

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“…Recently, however, rotation of the distal fragment has been added to correct greater deformity, 18,19 and some authors have recommended its use for patients with a moderate deformity. 17,36 In this study we focused on a comparison of DCO and PCO because these two procedures have been widely used and we have greater experience of them.…”

Section: Discussionmentioning

confidence: 98%

“…The classic Scarf osteotomy may be considered to be a type of distal osteotomy because it uses translation to correct the deformity, 17 whereas a Scarf osteotomy incorporating some angulation may be considered to be a type of proximal osteotomy. 18,19 Therefore, distal osteotomy may be used for the correction of mild deformity and proximal osteotomy for the correction of more severe deformity. Either method may be used for the patient with a moderate deformity.…”

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confidence: 99%

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A comparison of proximal and distal chevron osteotomy for the correction of moderate hallux valgus deformity

Park

et al. 2013

The Bone & Joint Journal

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The purpose of this study was to compare the results of proximal and distal chevron osteotomy in patients with moderate hallux valgus. We retrospectively reviewed 34 proximal chevron osteotomies without lateral release (PCO group) and 33 distal chevron osteotomies (DCO group) performed sequentially by a single surgeon. There were no differences between the groups with regard to age, length of follow-up, demographic or radiological parameters. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system and the radiological results were compared between the groups. At a mean follow-up of 14.6 months (14 to 32) there were no significant differences in the mean AOFAS scores between the DCO and PCO groups (93.9 (82 to 100) and 91.8 (77 to 100), respectively; p = 0.176). The mean hallux valgus angle, intermetatarsal angle and sesamoid position were the same in both groups. The metatarsal declination angle decreased significantly in the PCO group (p = 0.005) and the mean shortening of the first metatarsal was significantly greater in the DCO group (p < 0.001). We conclude that the clinical and radiological outcome after a DCO is comparable with that after a PCO; longer follow-up would be needed to assess the risk of avascular necrosis.

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Section: Discussionmentioning

confidence: 98%

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confidence: 99%

A comparison of proximal and distal chevron osteotomy for the correction of moderate hallux valgus deformity

Park

et al. 2013

The Bone & Joint Journal

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“…We believe these can be attributed to a loss of lateral translation during plate attachment to bone. DMAA [21] and metatarsus adductus angle [22] that were known risk factors for recurrence of hallux valgus were not found to be significantly different between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Plate fixation for proximal chevron osteotomy has greater risk for hallux valgus recurrence than Kirschner wire fixation

Park

Ahn

Kim

et al. 2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to compare the results of hallux valgus surgery between feet fixed with Kirschner wires and those fixed with a plate and screws. Methods Between December 2008 and November 2009, 53 patients (62 feet) were treated with proximal chevron osteotomy and distal soft tissue procedure for symptomatic moderate to severe hallux valgus deformity. Thirty-four patients (41 feet) were stabilised with Kirschner wires (K-wire group) and 19 patients (21 feet) were stabilised with a locking plate (plate group). Clinical results were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score. Radiographic parameters were compared between these groups. Recurrence rate at the last follow-up was compared between the K-wire and plate groups. Results Mean AOFAS score was lower in the plate group, however, the difference between the groups was not statistically significant in AOFAS score at the last follow-up. Hallux valgus angle and intermetatarsal angle were significantly larger in the plate group at the last follow-up. Mean 1-2 metatarsal (MT) distance on immediately postoperative radiographs was significant larger in the plate group. Four (9.8 %) of the 41 feet in the K-wire group and 7 (33.3 %) of the 21 feet in the plate group showed hallux valgus recurrence at the last follow-up. The plate group had a significantly higher risk of recurrence than the K-wire group. Conclusions Fixation of proximal chevron osteotomy using a plate and screws has a greater risk of hallux valgus recurrence than fixation using Kirschner wires.

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“…The Akin osteotomy of the proximal phalanx has been described for treatment of hallux interphalangeus and also has been reported in conjunction with the scarf osteotomy [4,15,16]. Similarly, we used the Akin osteotomy to address an interphalangeus deformity in association with an HV deformity and to address any changes in distal metatarsal articular angle (DMAA) alignment caused by the rotational osteotomy.…”

Section: Introductionmentioning

confidence: 99%

A Rotational Scarf Osteotomy Decreases Troughing When Treating Hallux Valgus

Murawski

Egan

Kennedy

2011

Clinical Orthopaedics &Amp; Related Research

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Background The traditional scarf osteotomy has been associated with complication rates between 1.1% and 45%. We have modified the traditional technique with a rotational osteotomy to reduce these complications. Questions/purposes We determined whether a modified rotational scarf osteotomy improves functional outcome scores, allows correction of a wide degree of an intermetatarsal (IM) angle deformity, has a low incidence of troughing, and maintains normal ROM postoperatively in the treatment of symptomatic hallux valgus (HV). Patients and Methods We retrospectively reviewed 140 patients: 38 men and 102 women with a mean age of 54 years (range, 35-66 years) who underwent surgery for HV and had a minimum followup of 24 months (mean, 41 months; range, 24-68 months). All patients had preoperative and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) forefoot and Short Form (SF)-36 V2 outcome scores recorded. Results The mean AOFAS score improved from 52 points preoperatively to 92 points (range, 71-96 points) at followup. The mean SF-36 V2 score improved from 69 points preoperatively to 94 points (range, 67-98 points) at followup. The IM angle improved from a preoperative mean of 18°(range, 9°-23°) to a mean of 8°(range, 6°-12°). Eleven patients experienced a complication. Conclusions The modified rotational scarf osteotomy has a low complication rate (9%) and apparently reduces the risk of troughing. This procedure can reduce a high degree of IM angle deformity while restoring function to the forefoot.

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Rotational Scarf and Akin Osteotomy for Correction of Hallux Valgus Associated with Metatarsus Adductus

Abstract: The rotation scarf & Akin osteotomy was an effective procedure for correcting hallux valgus associated with metatarsus adductus. It allowed good realignment of the first MTP joint without the need for lesser metatarsal surgery to reduce the metatarsus adductus.

Cited by 52 publications

References 33 publications

A comparison of proximal and distal chevron osteotomy for the correction of moderate hallux valgus deformity

A comparison of proximal and distal chevron osteotomy for the correction of moderate hallux valgus deformity

Plate fixation for proximal chevron osteotomy has greater risk for hallux valgus recurrence than Kirschner wire fixation

A Rotational Scarf Osteotomy Decreases Troughing When Treating Hallux Valgus

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