Abstract
Aim
Subjective and objective review of our early experience with scarf osteotomy for correction of Hallux valgus
Introduction
Scarf joint is a technique used by carpenters to increase the size of entrance by longitudinally joining beams of timbers.
Scarf osteotomy of the first metatarsal is a ‘Z’-osteotomy with inherent stability. The convalescence is short and complications of avascular necrosis and non-union are rarely reported. The combination of soft tissue procedure with the osteotomy consistently gives good correction of hallux valgus.
Methods and Results
The records, radiographs were reviewed and the subjective assessment by telephone interview. Forty-one patients had a scarf procedure but only 31 patients (37 scarf procedures) could be contacted by telephone.
All patients were females with a mean age of 44.6(16–76) years. Mean follow-up was 14 months(12 to 18 months).
The results were reviewed using the guideline recommended by the Research Committee of American Orthopaedic Foot and Ankle Society. Mean preoperative hallux valgus angle (HVA) was 30.4°(20–48°) and the postoperative HVA was 14.6°(9–22°). The mean pre-operative intermetatarsal angle (IMA) was 4.1°(10–22°) and postoperatively was 8.4°(5–12°). There was significant correction of the tibia sesamoid position (p=0.001). There was no avascular necrosis or non-union. Eighty-eight percent of patients were satisfied; two patients had infection and two stiff MTP joints.
Conclusion
Scarf osteotomy gives very good correction of hallux valgus and tibia sesamoid position. Patient satisfaction was good with a low complication rate, the fixation after the osteotomy was very stable and no post-operative splint was required.
The abstracts were prepared by Mr J. L. Barrie. Correspondence should be addressed to Mr J. L. Barrie, BOFSS Editor, Department of Orthopaedic Surgery, Blackburn Royal Infirmary, Blackburn, Lancashire BB2 3LR.
