Document Detail

A rotational scarf osteotomy decreases troughing when treating hallux valgus.
MedLine Citation:
PMID:  20976578     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The traditional scarf osteotomy has been associated with complication rates between 1.1% and 45%. We have modified the traditional technique with a rotational osteotomy to reduce these complications.
QUESTIONS/PURPOSES: We determined whether a modified rotational scarf osteotomy improves functional outcome scores, allows correction of a wide degree of an intermetatarsal (IM) angle deformity, has a low incidence of troughing, and maintains normal ROM postoperatively in the treatment of symptomatic hallux valgus (HV).
PATIENTS AND METHODS: We retrospectively reviewed 140 patients: 38 men and 102 women with a mean age of 54 years (range, 35-66 years) who underwent surgery for HV and had a minimum followup of 24 months (mean, 41 months; range, 24-68 months). All patients had preoperative and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) forefoot and Short Form (SF)-36 V2 outcome scores recorded.
RESULTS: The mean AOFAS score improved from 52 points preoperatively to 92 points (range, 71-96 points) at followup. The mean SF-36 V2 score improved from 69 points preoperatively to 94 points (range, 67-98 points) at followup. The IM angle improved from a preoperative mean of 18° (range, 9°-23°) to a mean of 8° (range, 6°-12°). Eleven patients experienced a complication.
CONCLUSIONS: The modified rotational scarf osteotomy has a low complication rate (9%) and apparently reduces the risk of troughing. This procedure can reduce a high degree of IM angle deformity while restoring function to the forefoot.
LEVEL OF EVIDENCE: Level IV, case series. See Guidelines for Authors for a complete description of levels of evidence.
Christopher D Murawski; Christopher J Egan; John G Kennedy
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Publication Detail:
Type:  Journal Article     Date:  2010-10-26
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:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  847-53     Citation Subset:  AIM; IM    
Department of Foot and Ankle Surgery, Hospital for Special Surgery, 523 East 72nd Street, Suite 514, New York, NY 10021, USA.
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MeSH Terms
Forefoot, Human / pathology,  surgery*
Hallux Valgus / pathology,  surgery*
Metatarsal Bones / abnormalities,  surgery*
Middle Aged
Osteotomy / adverse effects,  methods*
Postoperative Complications / etiology*
Range of Motion, Articular
Recovery of Function
Retrospective Studies
Sickness Impact Profile
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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