Abstract
This study was designed to assess the utility of the scarf osteotomy in the management of symptomatic adolescent hallux valgus.
Methods
This is a consecutive case series of 30 patients (40 feet) with a mean follow up of 38.2 months (range 6–60 months). The mean age at the time of surgery was 14.2 years (range 10–17 years). American Orthopaedic Foot and Ankle Society scores (AOFAS) were collected at final follow up, along with a rating of the overall satisfaction. Any complications were recorded. Pre and postsurgical radiographic angles were measured (HVA, IMA and DMAA) and analysed using the students ‘t’ test. A second surgeon additionally recorded the angles to measure the inter-rater reliability using the Pearson product moment correlation.
Results
The mean AOFAS score at final follow up was 91.2 (range 54–100). 87% of patients were either satisfied or very satisfied with their final outcome. 1 patient has been listed for revision surgery after symptomatic recurrence at 3 years follow up. Pre-op HVA, IMA and DMAA were 35.1, 16.1 and 16.3 respectively. Post-op values were 16.3, 8.8 and 9.0 (p < 0.001 for each). Pearson's r coefficient values demonstrated good inter-rater reliability of measurement.
Conclusion
We have presented the results of the largest case series of scarf osteotomies for adolescent hallux valgus reported in the literature at this point, as far as we are aware. AOFAS scores at final follow up are comparable to the smaller studies previously reported and provide evidence that good outcomes and high levels of patient satisfaction can be achieved. Early follow up demonstrates a low level of symptomatic recurrence, but longer term data is still required.
