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IS AN INTERNAL FIXATION NECESSARY IN A SCARF OSTEOTOMY IN BUNION SURGERY ? COMPARATIVE STUDY ABOUT 208 CASES.



Abstract

Introduction: The scarf osteotomy is a reliable technique in bunion surgery. A so-called « self stable technique» was developed in our department since 1992. We report the results of retrospective study including two groups of patients which had a scarf osteotomy. In the first group they had an internal fixation and in the second one an ‘selfstable technique’ with no device.

Material and methods: One hundred and seventy one patients operated for hallux valgus were reviewed for this study. There were 105 feet operated with the so called ‘self stable techniqu’, using modified saw cuts and 103 had the conventional technique with an internal fixation. All patients had a clinical and radiological pre- and postoperative examination. The result was assessed according to the AOFAS Score.

Results: The follow-up was on average 6.3 years (ranging from 2 to 13 years). The result was considered satisfactory globally in 74% of the cases, 76% in the « selfstable group and 72% in the conventional group. All items were significantly improved in both groups and the good results remained with time: improvement in shoe wear, pain, angular corrections. The hallux valgus angle decreased from 34° to 16°, there was no difference between both groups. The first intermetatarsal angle changed from 15° to 10. No significant difference was found in term on bone healing and complications between both groups.

Discussion: These results are comparable with those of the literature. The « selfstable technique » is significantly identical to the conventional one. The patients have the same rate of complications. The corrections that this osteotomy is able to offer are not altered by the change of fixation of the osteotomy.

Conclusion: This modified scarf osteotomy of the first metatarsal provides equivalent long-term results in our experience.

Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland