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