Document Detail


Outcomes after scarf osteotomy for treatment of adult hallux valgus deformity.
MedLine Citation:
PMID:  20706810     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Stephanie P Adam; Steven C Choung; Yang Gu; Martin J O'Malley
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-08-13
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-03     Completed Date:  2011-03-24     Revised Date:  2012-09-24    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  854-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Foot and Ankle Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA. StephaniePAdam@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Female
Forefoot, Human / pathology,  physiopathology,  surgery*
Hallux Valgus / pathology,  physiopathology,  surgery*
Humans
Male
Metatarsal Bones / abnormalities,  surgery*
Middle Aged
Osteotomy / adverse effects,  methods*
Patient Satisfaction
Postoperative Complications / etiology
Range of Motion, Articular
Recovery of Function
Rotation
Sickness Impact Profile
Treatment Outcome
Young Adult
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