Scarf osteotomy for the correction of moderate and severe degrees of hallux valgus

Abstract

Aim The aim of this study was to evaluate the clinical and radiological results of scarf osteotomy in correction of moderate and severe degrees of hallux valgus (HV). Patients and methods Between April 2011 and June 2014, 21 patients with 25 feet of moderate to severe HV deformity were included in this prospective study. The study was conducted to evaluate the clinical and radiological results of correction of moderate to severe HV deformity using scarf osteotomy. While a Z-shaped step-cut osteotomy was used to realign the first metatarsal bone, and another closing-wedge osteotomy of Akin osteotomy may be needed in severe cases to complete the correction of the proximal phalanx of the HV in 15 feet. There were five men and 16 women, with a mean age of 24 years. The mean follow-up time was 24 months. Results Overall, 84% of the patients were very satisfied, 12% were satisfied, and 4% were not satisfied. The mean American Orthopedic Foot and Ankle Society score improved significantly from 36 points preoperatively to 94 at the final follow-up. The intermetatarsal and HV angles improved from the mean preoperative values of 18° and 37° to 8° and 13°, respectively. Satisfactory healing time was expressed as an average return back to work after 6 weeks and back to sports after 12 weeks. Persistence or recurrence of HV was seen in one patient; wound infections occurred in two patients, which settled after the administration of antibiotics; and one patient required further surgery to remove a long distal screw. Conclusion The scarf osteotomy combined with the Akin closing-wedge osteotomy is safe and effective for the treatment of HV.