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Z-osteotomy in hallux valgus: clinical and radiological outcome after Scarf osteotomy

Marcus Jaeger, Michael Schmidt, Alexander Wild, Bernd Bittersohl, Susanne Courtois, Troy G. Schmidt, Rüdiger Krauspe
  • Michael Schmidt
    Orthopedic Clinic, Waldhof-Zentrum Kronberg, Germany
  • Alexander Wild
    Department of Orthopedics, Hessing Stiftung, Hessingstraße 17, 86199 Augsburg,
  • Bernd Bittersohl
    Department of Orthopedics, Heinrich-Heine University Medical School, Duesseldorf, Germany
  • Susanne Courtois
    Department of Orthopedics, Heinrich-Heine University Medical School, Duesseldorf, Germany
  • Troy G. Schmidt
    Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, USA, United States
  • Rüdiger Krauspe
    Department of Orthopedics, Heinrich-Heine University Medical School, Duesseldorf, Germany

Abstract

Correction osteotomies of the first metatarsal are common surgical approaches in treating hallux valgus deformities whereas the Scarf osteotomy has gained popularity. The purpose of this study was to analyze short- and mid-term results in hallux valgus patients who underwent a Scarf osteotomy. The subjective and radiological outcome of 131 Scarf osteotomies (106 hallux valgus patients, mean age: 57.5 years, range: 22-90 years) were retrospectively analyzed. Mean follow-up was 22.4 months (range: 6 months-5 years). Surgical indications were: intermetatarsal angle (IMA) of 12-23°; increased proximal articular angle (PAA>8°), and range of motion of the metatarsophalangeal joint in flexion and extension >40°. Exclusion criteria were severe osteoporosis and/or osteoarthritis. The mean subjective range of motion (ROM) of the great toe post-surgery was 0.8±1.73 points (0: full ROM, 10: total stiffness). The mean subjective cosmetic result was 2.7±2.7 points (0: excellent, 10: poor). The overall post-operative patient satisfaction with the result was high (2.1±2.5 points (0: excellent, 10: poor). The mean hallux valgus angle improvement was 16.6° (pre-operative mean value: 37.5°) which was statistically significant (p<0.01). The IMA improved by an average of 5.96° from a pre-operative mean value of 15.4° (p<0.01). Neither osteonecrosis of the distal fragment nor peri-operative fractures were noted during the follow-up. In keeping with our follow-up results, the Scarf osteotomy approach shows potential in the therapy of hallux valgus. 筻

Keywords

Hallux Valgus, Foot, Scarf Osteotomy, follow-up after treatment

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Submitted: 2009-04-26 13:05:50
Published: 2009-05-14 17:09:43
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Copyright (c) 2009 Marcus Jaeger, Michael Schmidt, Alexander Wild, Bernd Bittersohl, Susanne Courtois, Troy G. Schmidt, Rüdiger Krauspe

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