Short-term evaluation of combined Scarf and Akin osteotomies for treatment of hallux valgus

Abstract

Background Despite Scarf osteotomy was described earlier in the 20th century, it was popularized later in 2000 after modification of the original technique. The combined Scarf–Akin osteotomies were described for surgical correction of the hallux valgus, but with no significant consideration for the patient satisfaction. Patients and methods Twenty-three patients with unilateral painful hallux valgus deformity were treated with combined Scarf and Akin osteotomies. All patients were evaluated clinically (using American Orthopedic Foot and Ankle Society-Hallux Metatarsophalangeal–Interphalangeal scale scores) and radiologically (hallux valgus angle, intermetatarsal angle, union, evidence of degenerative changes, and joint congruity) after 12 months of follow-up. All the patients were then asked about their satisfaction and if they would undergo the same surgery under similar circumstances in the future. Results There were 15 females and eight males with an average age 38.8 ± 2.4 years. The mean preoperative American Orthopedic Foot and Ankle Society was 55.4 that significantly improved to 87.2 postoperatively (P<0.001). There was a significant reduction of the mean hallux valgus angle and the mean intermetatarsal angle preoperatively and postoperatively (P=0.03 and 0.034, respectively). One patient complained of a prominent screw postoperatively, while two patients suffered from superficial wound infection. At 12 months postoperatively, all operated patients were satisfied with their results and indicated that they would be happy to undergo surgery again under similar circumstances. Conclusion Despite the short follow-up period in our study, the combined Scarf and Akin osteotomies are a safe and effective method for treatment for hallux valgus deformity that provides statistically significant clinical and radiographic improvements with excellent patient satisfaction. Level of evidence Level-IV case-series study.