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SCARF OSTEOTOMY FOR CORRECTION OF HALLUX VALGUS CLINICAL, RADIOLOGICAL AND FUNCTIONAL OUTCOME



Abstract

The fact that a multitude of procedures exist for the correction of hallux valgus indicates that there is no ideal operation for this problem. Hallux valgus correction can be significantly improved by scarf first metatarsal osteotomy. The surgical technique is versatile and strong internal fixation allows early functional recovery. The aim of our study is to analyse the clinical, radiological and functional outcome after scarf osteotomy for hallux valgus correction.

Material and Methods: The scarf osteotomy was performed on 65 feet of 48 patients between 1996 and February 2001. The indication was a symptomatic hallux valgus with increased intermetatarsal angle (IMA). The osteotomy was fixed with one/two 2.3mm screws. Mobilisation was allowed with full weight bearing with forefoot orthesis. Fifty-one cases in 39 female patients (12 bilateral feet) were available for follow-up. The mean follow-up was 14 months (range 3–36 months). Patients were interviewed, clinically examined and standing radiographs of operated foot were taken. They were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) Hallux Metatarsophalyngeal Inter-phalyngeal clinical rating system in which 100 point are used to compare preoperative and postoperative pain, function and range of motion, shoe wear comfort and activity level and alignment.

Results: All osteotomies healed at the time of follow-up. The average value of AOFAS scale was 92 points. Five patients had removal of screws. There were 4 cases of superficial wound infection. All patients have excellent cosmetic and functional results.

Conclusion: Our study has demonstrated that scarf osteotomy has proven to offer easy postoperative care and has excellent stable long-term results.

The abstracts were prepared by Mr Ray Moran. Correspondence should be addressed to him at Irish Orthopaedic Associaton, Secretariat, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11.