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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 3/2011

01-03-2011 | Clinical Research

Outcomes after Scarf Osteotomy for Treatment of Adult Hallux Valgus Deformity

Authors: Stephanie P. Adam, DO, Steven C. Choung, MD, Yang Gu, BS, Martin J. O’Malley, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 3/2011

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Abstract

Background

Many procedures have been developed to correct hallux valgus deformity using distal soft tissue realignment, metatarsal osteotomy, and periodically, a proximal phalanx osteotomy (Akin). The ideal metatarsal osteotomy allows for varying degrees of correction with reliable improvement in deformity and patient satisfaction.

Questions/purposes

We evaluated the results after scarf osteotomy with respect to American Orthopaedic Foot and Ankle Society (AOFAS) scores, patient satisfaction, radiographic results, and complications.

Patients and Methods

We evaluated 29 patients (34 feet) during an 18-month period who underwent a unilateral scarf osteotomy combined with distal soft tissue realignment. Preoperative and postoperative AOFAS scores, patient satisfaction, and radiographic data were used to evaluate the effectiveness of the procedure. Complications were recorded. Minimal followup was 12 months (average, 26.4 months; range, 12–48 months).

Results

The mean AOFAS scores improved from 61.5 to 90.3. At final followup, 94% of patients were satisfied with the surgery. The hallux valgus angle improved from 34.6° to 14.9° and the intermetatarsal angle improved from 15.8° to 7.2° postoperatively. A combined Akin osteotomy was performed in only four cases. Complications included superficial wound infection (one), recurrence (two), and troughing (three).

Conclusions

Our results suggest the scarf osteotomy produces improved AOFAS scores, high percentage of patient satisfaction, and effective correction of hallux valgus deformities. Using our scarf technique of rotation combined with translation minimizes the need for an Akin osteotomy while still obtaining good correction and avoids associated complications described in the literature.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Metadata
Title
Outcomes after Scarf Osteotomy for Treatment of Adult Hallux Valgus Deformity
Authors
Stephanie P. Adam, DO
Steven C. Choung, MD
Yang Gu, BS
Martin J. O’Malley, MD
Publication date
01-03-2011
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 3/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-010-1510-6

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