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A Rotational Scarf Osteotomy Decreases Troughing When Treating Hallux Valgus

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

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.

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Acknowledgment

We acknowledge and sincerely thank TriMed, Inc. for use of the surgical technique illustrations of the Scarf osteotomy seen in this manuscript.

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Authors and Affiliations

  1. Department of Foot and Ankle Surgery, Hospital for Special Surgery, 523 East 72nd Street, Suite 514, New York, NY, 10021, USA

    Christopher D. Murawski, Christopher J. Egan RPA-C & John G. Kennedy MD FRCS (Orth)

Authors
  1. Christopher D. Murawski
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  2. Christopher J. Egan RPA-C
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  3. John G. Kennedy MD FRCS (Orth)
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Corresponding author

Correspondence to Christopher D. Murawski.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Murawski, C.D., Egan, C.J. & Kennedy, J.G. A Rotational Scarf Osteotomy Decreases Troughing When Treating Hallux Valgus. Clin Orthop Relat Res 469, 847–853 (2011). https://doi.org/10.1007/s11999-010-1647-3

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  • DOI: https://doi.org/10.1007/s11999-010-1647-3

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