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

Abstract

Background The Scarf osteotomy was described as a technique to correct a metatarsus primus varus in primary hallux valgus surgery, but it is unclear whether the technique could correct recurrent hallux valgus when an initial procedure failed to provide any or an adequate lateral displacement of the metatarsal head. Questions/purposes We asked whether the Scarf osteotomy could reduce pain, improve the AOFAS score, reduce the deformity, and prevent further recurrence when used as a revision procedure. Patients and Methods Of 41 patients (45 feet) we treated for failed initial operations, we retrospectively reviewed 35 (39 feet) who underwent a Scarf osteotomy. We administered a VAS for pain and the AOFAS score preoperatively and postoperatively. Preoperative and postoperative radiographs were taken to assess the hallux valgus angle [HVA] and intermetatarsal angle [IMA]. The minimum followup was 24 months (mean, 42 months; range, 24-89 months). Results The mean VAS for pain improved from 5.9 to 0.4 points. The mean AOFAS score improved from 56 to 90 points. The radiographic evaluation showed improvement of the mean HVA from 30°to 8°and improvement of the IMA from 13°to 4°. Complications included one asymptomatic recurrence with a 20°-HVA, one overcorrection with a

Scarf osteotomy versus metatarsophalangeal arthrodesis in forefoot first ray disorders: Comparison of functional outcomes

“…Function after MTP1 arthrodesis was found to be globally satisfying and durable in a study by Groulier et al [6]. Most series of Scarf osteotomy and MTP1 arthrodesis use the AOFAS score to evaluate functional criteria by comparing global preoperative and postoperative scores: the increase is comparable in all series with a gain of approximately 30 points [4,19,[22][23][24][25]. Nevertheless, the score items are not usually listed in detail.…”

Revisional Surgery for Hallux Valgus with Serial Osteotomies at Two Levels

“…Although it allows correction of a metatarsus primus varus deformity in primary HV, it was uncertain if a Scarf osteotomy alone would allow correction of both metatarsal primus varus and the DMAA deformity. In appropriately selected patients, Bock et al suggested that, as a revision procedure, the Scarf osteotomy had a good outcome of clinically and radiographically corrected recurrent HV recurrence in most patients [9].…”

Ostéotomie de type Scarf versus arthrodèse métatarsophalangienne dans la pathologie du premier rayon : comparaison des résultats fonctionnels

“…Pour l'arthrodèse, il est rapporté des erreurs de positionnement dans 3 à 20 % des cas [6], une surcharge de l'articulation interphalangienne dans 5 % [7] [4,19,[22][23][24][25]. Toutefois, généralement les items du score ne sont pas détaillés.…”