Abstract
Introduction
The aim of this study was to assess whether routine X-Rays at six weeks altered the subsequent management of patients who underwent a Scarf osteotomy.
Materials and Methods
Between 1997 and 2010, 218 consecutive primary scarf osteotomies of the first metatarsal were performed by two foot and ankle surgeons in a single unit. 71 were combined with an Akin closing wedge osteotomy of the proximal phalanx of the great toe and soft tissue release. Additional osteotomies were performed on the lesser toes in 30 cases. Intraoperative X-Rays were taken. We retrospectively looked at clinic letters for all patients who attended six weeks post operatively and recorded the outcomes following X-Rays.
Results
209 patients were assessed six weeks post operatively with radiographs of the foot. 9 patients were lost to follow up. Four patients (1.9%) were identified as having complications at the osteotomy: recurrence of deformity seen in two patients, delayed union with failure of fixation, and painless hypertrophic nonunion.
Discussion
Only a very small proportion of patients developed complications at the osteotomy site following a Scarf osteotomy for hallux valgus. Both cases of recurrence were diagnosed clinically. Failure of fixation was due to poor patient compliance. No revision procedures were planned for any patients.
Conclusion
The senior author no longer requests postoperative X-Rays routinely. We believe that the majority of patients may be safely and successfully assessed clinically following Scarf osteotomy without the need for routine X-Rays.
