The Lapidus Procedure as Salvage After Failed Surgical Treatment of Hallux Valgus

The Scarf Osteotomy: A Salvage Procedure for Recurrent Hallux Valgus in Selected Cases

“…The amounts of reduction of the HVA and IMA are similar to those of TMT1 fusion [8] and proximal osteotomy [17], differing only by up to 2° (Table 8); MTP1 arthrodesis generally achieves less reduction of the HVA and IMA (Table 8). The average shortening in our patients was 1.9 mm.…”

“…The average shortening in our patients was 1.9 mm. Shortening of 2.7 mm for TMT1 fusion is slightly greater [8]. Primary use of TMT1 fusion shows shortening rates of 4 mm [4], 4.7 mm [5], 4.5 mm [22], and 5 mm [27].…”

“…Not every patient with complaints after primary hallux valgus surgery was eligible for the Scarf osteotomy; however, our aim was to determine whether the Scarf osteotomy was reasonable for treating recurrent hallux valgus in a selected group of patients sharing a similar pathomechanism. We did not consider this operation in patients for whom we considered other methods to be more suitable (eg, cock-up deformity, unstable TMT1) [8,9,19,21]. Third, we lacked historical or concurrent controls.…”

“…A substantial reduction was observed in our patients. Only three other studies [8,10,14] report on reduction of pain measured by a VAS (Table 8). Our patients had the lowest postoperative level of pain.…”

“…Various studies, however, propose the following methods: arthrodesis of the first metatarsal-cuneiform joint [8], arthrodesis of the first metatarsophalangeal (MTP1) joint [10,14,18,21,33,34], repeat resection arthroplasty [18,21], and proximal osteotomy [17]. The Scarf osteotomy was described as a technique for primary correction of a metatarsus primus varus [23] and used by many subsequent authors [2,3,13,15,20].…”