engleski

Scarf osteotomies in hallux valgus correction

1 INTRODUCTION The study describes the possibilities for hallux valgus correction employing scarf osteotomies. The authors present the results of achieved correction 6 months after surgery. 2 METHODS Twentyseven female patients with hallux valgus deformation have been treated with first metatarsal scarf osteotomy and distal soft tissue procedure. The average age was 50 years (22-83, median 50). Three pateints were operated bilateraly, two of them in one procedure. All pateints were followed at least six months after operation. In one patient short scarf osteotomy was done, and in five short scarf first metatarsal osteotomy and Akin phalangeal osteotomy. Long scarf osteotomy was performed in eight patients, and additionaly Akin osteotomy was done in thirteen patients. FRS were used for scarf osteotomy fixation, and Akin osteotomy has been fixed with FRS or Barouk clamph. Special Barouk shoe has been used for 4 weeks after procedure, and full weight bearing was allowed 6 weeks after surgery. 3 RESULTS Average first metatarsal angle (IMT) before procedure was 15±4 deg. (9-31 deg., median 15 deg.), and after procedure 5±2 deg. (2-13 deg., median 4 deg.). The average hallux valgus angle (HV) was 31±8 deg. (16-48 deg., median 32 deg.), and 12±7 deg. (2-35 deg., median 11 deg.) after operation. Both differences were statisticaly significant on the level of 5%. The average width of diaphyseal fragment translation was 49±13% (17-80%, median 50%) of the first metatarsal diaphyseal width. There is positive correlation of the translation amount and the angle of valgus (HV) correction. After the procedure there were no infections or stiffnes. In two patients revalgisation occurred, and one of them was reoperated. 4 DISCUSSION The two patients were not satisfied with the outcome of operative treatment, and two are partialy satisfied. All other patients were satisfied or very satisfied with the final result. Scarf osteotomy is very safe method for correction of hallux valgus deformity and one can expect optimal result. The amount of diaphyseal translation correlate with degree of hallux valgus angle correction.

scarf osteotomy; treatment

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