Purpose: The advantages of the Scarf osteotomy are the greater ROM and the ability of better Stabilisation. We had compared our results with this theory.

Methods-Results: At 41 patients with mean age 52,5, y(16–70) we made 47 Scarf osteotomies. At 25 patients we made also corrective osteotomies at the kleiner toes.

The preoperative criteria for our study were degenerative Osteoarthritis of the 1st MP joint, HV angle> 40° or IM I-II angle> 20°.

The postoperative and radiologic control was continued for 11–18 months(M. 18m)

38 patients were very satisfied with the results,2 sat-isfied, 1 patient was claimed for reduced ROM of the 1st PIP joint. The mean rehabilitation time was 2,9 months(1,5–6M).

Pre- and postoperative compare had shown a change at AOFAS score from 48 (19–80) to 87 (35–100),change of the HVA from 35,2° (29°–48°) to 16°(4°–33°) and change of the IM I-II angle from 14,7°(11°–19°) to 8,4°(6°–12°).

The DMAA didn’t show any particular change. The major shortening of the 1st Metatarsal was 3mm.

A t 1 patient we find early osteoarthitic changes, but we have seen no pseudarthrosis or Metatarsal Head Necrosis. At 10 patients we measured the 1st MP joint ROM< 75° and at 1 patient < 30°.

Conclusions: The Scarf osteotomy with the modified Mc Bride procedure is an effective method for the treatment of Hallux Valgus.

Material-Methods: At 18 patients with Seronegative Chronic Polyarthritis(16 women, 2men, M.A 64,5 y) we made 24 Hoffmann-Tillmann procedures at the forefoot (6 right,6 left,6 both).At 2 patients we repeated the operation due to pseudarthrosis, at 2 patients we applied a corrective operation at the 2nd toe and at 1 patient we removed the osteosynthesis materials.

The postoperative and Radiologic control of 15 patients(20 foots) was continued for 1,5–7,5 y(M.3,5y).We had phone contact with 2 patients and for 1 patient, who died, we used the latest evaluation.

All the patients were satisfied with the postoperative results. Walking and shoe use were incompliant. At 2 patients we mentioned slight hyperextension of the 1st MP joint and at 2 patients asymptomatic pseuthasrthrosis of the 1st MP joint.

The M.V. of the HV angle was 17° and the inclination angle between Metatarsals and toes was 20°.The Phalanges showed mild to major degree Osteoporosis. The Hallux AOFAS Score was 83 (49–90) and for the remain toes 89,5(79–97).The results according to Mielke Score were very good at 15 foots and good at 5 foots.

Conclusions: Arthrodesis of the 1st MP joint in combination with head resection of the II-V Metatarsals is a very effective method for the treatment of the Rheumatoid foot.