Scarf Osteotomy for the Correction of Hallux Valgus: Midterm Clinical Outcome

Lipscombe, S.; Molloy, Andy; Sirikonda, Siva; Hennessy, M. S.

doi:10.1053/j.jfas.2008.02.021

Cited by 59 publications

(36 citation statements)

References 8 publications

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“…Our results show excellent correction of HVA and IMA, also comparable to rates reported in the literature [13,15].…”

Section: Discussionsupporting

confidence: 91%

“…Other studies have showed similar improvements in AOFAS scores: Kristen et al 50.1 to 91 [14], Lipscombe et al 47.9 to 96.1 [15], and Jones et al 52 to 89 [13].…”

Section: Discussionmentioning

confidence: 73%

“…This osteotomy is used widely in France and the United States and continues to evolve and increase in popularity in the surgical community [19,22]. Use of the proximal phalanx (Akin) osteotomy as an adjunct to the scarf osteotomy has been described frequently [7,13,15,16]. It routinely is added after completing the scarf osteotomy and soft tissue reconstruction when the hallux is still in greater than 10°valgus [14].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes after Scarf Osteotomy for Treatment of Adult Hallux Valgus Deformity

Adam

Choung

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Many procedures have been developed to correct hallux valgus deformity using distal soft tissue realignment, metatarsal osteotomy, and periodically, a proximal phalanx osteotomy (Akin). The ideal metatarsal osteotomy allows for varying degrees of correction with reliable improvement in deformity and patient satisfaction. Questions/purposes We evaluated the results after scarf osteotomy with respect to American Orthopaedic Foot and Ankle Society (AOFAS) scores, patient satisfaction, radiographic results, and complications. Patients and Methods We evaluated 29 patients (34 feet) during an 18-month period who underwent a unilateral scarf osteotomy combined with distal soft tissue realignment. Preoperative and postoperative AOFAS scores, patient satisfaction, and radiographic data were used to evaluate the effectiveness of the procedure. Complications were recorded. Minimal followup was 12 months (average, 26.4 months; range, 12-48 months). ResultsThe mean AOFAS scores improved from 61.5 to 90.3. At final followup, 94% of patients were satisfied with the surgery. The hallux valgus angle improved from 34.6°to 14.9°and the intermetatarsal angle improved from 15.8°to 7.2°postoperatively. A combined Akin osteotomy was performed in only four cases. Complications included superficial wound infection (one), recurrence (two), and troughing (three). Conclusions Our results suggest the scarf osteotomy produces improved AOFAS scores, high percentage of patient satisfaction, and effective correction of hallux valgus deformities. Using our scarf technique of rotation combined with translation minimizes the need for an Akin osteotomy while still obtaining good correction and avoids associated complications described in the literature.

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“…Our results show excellent correction of HVA and IMA, also comparable to rates reported in the literature [13,15].…”

Section: Discussionsupporting

confidence: 91%

“…Other studies have showed similar improvements in AOFAS scores: Kristen et al 50.1 to 91 [14], Lipscombe et al 47.9 to 96.1 [15], and Jones et al 52 to 89 [13].…”

Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes after Scarf Osteotomy for Treatment of Adult Hallux Valgus Deformity

Adam

Choung

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…The functional outcome scores, degree of correction, and complications after the traditional scarf osteotomy have been described [4,5,8,10,13,18]. Although functional outcome scores ranging from 62 to 96 points [4,5,8,10,13,18] have been reported for correction of mild to moderate cases of HV, potential complications exist, including troughing of the first metatarsal (1%-35%) [6,7] and postprocedure residual stiffness of the first metatarsophalangeal (MTP) joint (11%-41.7%) [11,13].…”

Section: Introductionmentioning

confidence: 99%

“…Although functional outcome scores ranging from 62 to 96 points [4,5,8,10,13,18] have been reported for correction of mild to moderate cases of HV, potential complications exist, including troughing of the first metatarsal (1%-35%) [6,7] and postprocedure residual stiffness of the first metatarsophalangeal (MTP) joint (11%-41.7%) [11,13]. A translational scarf osteotomy is limited by the degree of IM angle to which it can correct safely without increasing the risk of troughing of the first metatarsal.…”

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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Dynamic plantar pressure analysis and midterm outcomes in percutaneous correction for mild hallux valgus

Nova

Sánchez-Rodríguez

Leal-Muro

et al. 2011

Journal Orthopaedic Research

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Mild hallux valgus (HV), which can lead to alteration of the plantar pressure pattern with an overpressure under the hallux, can be repaired percutaneously. Our goals were to determine whether the percutaneous distal soft tissue release (DSTR)-Akin procedure restores the loading pattern and to evaluate which are the determinants of the measures of post-operative outcome. Seventynine percutaneous DSTR-Akin procedures were performed in the same number of patients. The plantar pressure patterns were evaluated using the BioFoot/IBV 1 in-shoe system and compared with measurements from 98 controls. The clinical and radiological outcome parameters measured were the pre-and post-operative AOFAS scores, and the first intermetatarsal, hallux abductus, and first metatarsal-hallux declination angles (FIMA, HAA, FMHDA) in weight-bearing radiographs. The mean follow-up was 28.1 (range 24-33) months. The plantar pressure analysis showed a significant decrease (328-152 kPa, p ¼ 0.001) in the mean pressure under the hallux. Significant improvements occurred in the AOFAS scores, and angular deviations were reduced. The post-operative HAA correlated with the mean pressure under the 1st toe (r 2 ¼ 0.132, p < 0.001). The DSTR-Akin percutaneous technique in mild HV restores physiological patterns of pressure on the hallux and achieves significant correction of radiographic angles and commensurate improvement in clinical status. ß

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Scarf Osteotomy for the Correction of Hallux Valgus: Midterm Clinical Outcome

Cited by 59 publications

References 8 publications

Outcomes after Scarf Osteotomy for Treatment of Adult Hallux Valgus Deformity

Outcomes after Scarf Osteotomy for Treatment of Adult Hallux Valgus Deformity

A Rotational Scarf Osteotomy Decreases Troughing When Treating Hallux Valgus

Dynamic plantar pressure analysis and midterm outcomes in percutaneous correction for mild hallux valgus

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