The results of Scarf osteotomy combined with distal soft tissue procedure are mostly satisfactory in surgical management of moderate to severe hallux valgus

Background

Intrinsically stable diaphyseal osteotomy gained popularity in recent years for symptomatic hallux valgus deformities. In this study, Scarf osteotomy results, in surgical management of moderate to severe hallux valgus, are presented.

Methods and patients

Study group consisted of 40 feet of 32 (28 females, four males) patients surgically managed by Scarf osteotomy between September 2009 and 2011, with a mean age of 52,98 (range, 31–75) years at the time of surgery. Patient satisfaction and VAS were used for subjective evaluation while for objective measures AOFAS score, first metatarsophalangeal joint ROM and radiological measurements (intermetatarsal, hallux valgus and distal metatarsal articular angles) were evaluated.

Results

Mean follow-up period was 38 (range, 24–60) months. Sixteen feet (40%) were reported as very satisfied, 19 (47,5%) as satisfied and the remaining five (12,5%) as unsatisfied resulting with a total of 35 (87,5%) satisfaction. The mean preoperative VAS and AOFAS forefoot scores improved from 8,13 ± 0,791 to 2,68 ± 1,228 (p = 0,0001) and from 58,25 ± 6,15 to 78,25 ± 8,13 (p = 0,0001) on the final follow-up, respectively. The postoperative change of first metatarsophalangeal joint ROM was not statistically significant (p = 0,281). On the radiological evaluation; intermetatarsal and hallux valgus angles improved from a mean value of 14,77 ± 1,76 to 8,13 ± 1,52° (p = 0,0001) and from 35,28 ± 5,86 to 20,10 ± 5,55° (p = 0,0001), respectively. Distal metatarsal articular angle did not show any statistically significant change (p = 0,195).

Conclusion

Scarf osteotomy combined with distal soft tissue procedure is a technically demanding procedure. The osteotomy is intrinsically stable and the correction power is high and the results are mostly satisfactory.