Scarf osteotomy for the treatment of moderate to severe hallux valgus: Analysis of predictors for midterm outcomes and recurrence |
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| Affiliation: | 1. Department of Orthopaedic and Trauma Surgery, “Magna Græcia” University, “Mater Domini” University Hospital, V.le Europa, (loc. Germaneto), 88100, Catanzaro, Italy;2. Aberdeen Royal Infirmary, Foresterhill Health Campus, Aberdeen, UK;1. Applied Mechanics and Bioengineering Group (AMB), Aragón Institute of Engineering Research (I3A), Universidad de Zaragoza, Spain;2. Orthopaedics and Trauma Department, Medicine School, Universidad Complutense Hospital Universitario Infanta Leonor, Madrid, Spain;3. Facultad de Ciencias Médicas, Universidad Espíritu Santo, Ecuador;1. Department of Orthopaedics, Akershus University Hospital, Norway;2. Institute of Clinical Medicine, University of Oslo, Norway;3. Department of Orthopaedics, Østfold Hospital, Norway;4. Department of Pulmonary Medicine, Medical Division, Akershus University Hospital, Norway;5. Health Services Research Unit, Akershus University Hospital, Norway;1. Clínica Alemana de Santiago – Universidad del Desarrollo, Av. Vitacura 5951, Vitacura, Santiago, 7650568 Chile;2. Hospital Militar de Santiago – Universidad de los Andes, Av. Plaza 2501, Las Condes, Región Metropolitana, Santiago, 7620157 Chile;3. Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 4 Newark St., Whitechapel, London, E1 2AT, UK;1. Department of Orthopaedics and Traumatology, Gazi University Faculty of Medicine, Ankara, Turkey;2. Sungurlu State Hospital, Turkey;1. Dept. of Orthopedic Surgery, Hvidovre Hospital, Copenhagen University Hospital, Denmark;2. Human Movement Analysis Laboratory, Dept. of Orthopedic Surgery, Hvidovre Hospital, Copenhagen University Hospital, Denmark;3. Clinical Orthopedic Research Centre, Hvidovre Hospital, Copenhagen University Hospital, Denmark;4. Department of Orthopedic Surgery, Sjaelland University Hospital, Køge, Denmark |
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| Abstract: | BackgroundControversies remain regarding the predictors for outcomes and recurrence after scarf osteotomy for hallux valgus deformity.MethodsSixty-two patients (70 feet) underwent scarf osteotomy for hallux valgus deformity. The radiological angles, tibial sesamoid position, articular congruence, demographics, comorbidities, AOFAS, VAS and SF-12 scores, and the postoperative compliance were tested as predictors for outcomes and recurrence.ResultsAfter a mean 38 ± 15.4 months follow-up, all of the radiological angles, the total AOFAS, PCS-12 and VAS scores significantly improved (all P < 0.001). Preoperative MCS-12 was directly related to the total postoperative AOFAS score (P = 0.003). A higher number of cardiovascular risk factors negatively affected the postoperative total AOFAS score, VAS and PCS-12 (β = −3.42, P = 0.030; β = 0.262, P = 0.022; β = −0.181, P = 0.025, respectively). The BMI influenced postoperative PCS-12 (β = −0.244, P = 0.002). Preoperative HVA was directly related to postoperative DMAA (P = 0.002) and tibial sesamoid position (P = 0.005). Preoperative joint incongruence and postoperative noncompliance were associated with recurrence (P = 0.043 and P = 0.035, respectively).ConclusionsSatisfactory results can be expected after scarf osteotomy. Higher BMI and number of cardiovascular risk factors, and low mental status should be carefully considered when counselling patients for this procedure. Adherence to postoperative care instructions influences deformity recurrence. |
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| Keywords: | Hallux valgus Scarf osteotomy AOFAS SF-12 Predictors Recurrence |
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