Scarf osteotomy for hallux valgus

Abstract

We prospectively reviewed 24 patients (35 feet) who had been treated by a Scarf osteotomy and Akin closing-wedge osteotomy for hallux valgus between June 2000 and June 2002. There were three men and 21 women with a mean age of 46 years at the time of surgery. The mean follow-up time was 20 months. Our results showed that 50% of the patients were very satisfied, 42% were satisfied, and 8% were not satisfied. The mean American Orthopaedic Foot and Ankle Society score improved significantly from 52 points pre-operatively to 89 at follow-up (p < 0.001). The intermetatarsal and hallux valgus angles improved from the mean pre-operative values of 15 degrees and 33 degrees to 9 degrees and 14 degrees, respectively. These improvements were significant (p < 0.0001). The change in the distal metatarsal articular angle was not significant (p = 0.18). There was no significant change in the mean pedobarographic measurements of the first and second metatarsals after surgery (p = 0.2). The mean pedobarographic measurements of the first and second metatarsals at more than one year after surgery were within the normal range. Two patients had wound infections which settled after the administration of antibiotics. One patient had an intra-operative fracture of the first metatarsal and one required further surgery to remove a long distal screw which was irritating the medial sesamoids. We conclude that the Scarf osteotomy combined with the Akin closing-wedge osteotomy is safe and effective for the treatment of hallux valgus.

Outcome of the scarf osteotomy in adolescent hallux valgus

“…Early radiological evaluation revealed significant improvement in the mean HVA, IMA and DMAA, and patients were happy with the outcome. This finding is consistent with that reported in the literature for scarf osteotomy in the adult population [25][26][27].…”

Correction osteotomy of the first phalanx of the great toe (Akin osteotomy)

“…AOFAS Score improved from 44 (16-75) points preoperatively to 76 (32-95) points [16] (Table I). The position of medial sesamoid according to Hardy und Clapham improved from 5.3 (2-7) preoperatively to 2.8 (1)(2)(3)(4)(5) at follow-up [17]. Surgical revision rate was 4% (2 patients underwent wound revision, 2 patients had scarf screw removal and 1 case had reosteosynthesis after dislocated Akin-staple witch then healed without complication).…”

“…Since that time this technique and its modifications have been widely in clinical use and were mostly described as additional correction manoeuvre combined with standard metatarsal osteotomies like scarf [2,3] or chevron osteotomies [4,5]. As the so-called Akin osteotomy mostly is used as a surplus procedure scientific evaluation of this osteotomy itself can rarely be found [6,7,8].…”

Symptomatic Medial Exostosis of the Great Toe Distal Phalanx: A Complication Due to Over-correction Following Akin Osteotomy for Hallux Valgus Repair

“…After discussion of the surgical options and potential risks and complications, surgical correction of the hallux valgus deformity was performed by means of a scarf osteotomy (8,9) of the first metatarsal combined with the use of an Akin adductory closing-wedge osteotomy (10) of the proximal phalanx. The surgery proceeded without apparent incident, and so too did the initial postoperative healing phase.…”