Scarf and Weil osteotomies for correction of rheumatoid forefoot deformities: A review of 20 cases |
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| Institution: | 1. Slotervaart Hospital, Department of Orthopaedic Surgery, The Netherlands;2. University Hospital Groningen, Department of Surgery, The Netherlands;3. Free University Hospital Amsterdam, Department of Orthopaedic Surgery, The Netherlands;1. Department of Orthopaedic Surgery, University of Texas Health Science Center-Houston, 10905 Memorial Hermann Drive, Suite 130 Pearland, Houston, TX 77584, USA;2. Private Practice Orthopaedics, 1 W Medical Ct Wichita Falls, Wichita Falls, TX 76310, USA;1. Director and Head, Orthopedic Department, Noble Hospital, Hadapsar, Pune, Maharashtra, India;2. Research Officer, Noble Hospital, Hadapsar, Pune, Maharashtra, India;3. Consultant Orthopaedic Surgeon, Orthopedic Department, Abane Hospital, Hadapsar, Pune, Maharashtra, India;4. Consultant Orthopaedic Surgeon, Orthopedic Department, Noble Hospital, Hadapsar, Pune, Maharashtra, India;1. Professor, Department of Orthopedic Surgery and Traumatology, Clínica Universidad de Navarra, Pamplona, Spain;2. Professor, Department of Orthopedic Surgery and Traumatology, Fundación Hospital de Calahorra, Logroño, Spain;3. Professor, Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain;4. Assistant Professor, Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain;1. Department of Orthopaedic Surgery, Faculty of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan;2. Department of Orthopaedics and Rheumatology, Nishino Clinic, Kita-ku, Tokyo, Japan |
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| Abstract: | The forefoot is commonly affected in rheumatoid arthritis. Little has been written of the results of metatarsophalangeal joint preservation in rheumatoid arthritis. We describe the results of the Scarf and Weil osteotomy for correction of forefoot deformities in patients with rheumatoid arthritis. Between 1996 and 1999, 17 patients (20 feet) underwent a Scarf osteotomy for their hallux valgus deformity and in 17 feet a Weil osteotomy of the lesser metatarsophalangeal joints. Radiographic examination was performed preoperatively and at a mean follow up of 65 months. A questionnaire was used at a minimum follow up of 6 years. The hallux valgus angle improved from 41° to 28° at follow up. The majority of the patients (79%) were satisfied with the result during follow-up. We found no wound infections, neuralgia or osteonecrosis of the first metatarsal. In three patients, a fusion of the first MTP joint was performed at follow up.In conclusion, the Scarf and Weil osteotomy is a useful method for MTP joint preserving surgery in rheumatoid forefoot deformities without severe impairment of the MTP joints. |
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