Abstract
Introduction
The scarf osteotomy is a z-osteotomy of the first metatarsal. This is a technically demanding procedure which allows early ambulation without cast and early return of function. This study was conducted to evaluate clinical results following this procedure in a district general hospital.
Method
We prospectively collected the data from 67 feet in 53 consecutive patients followed up for six months. Four patients were lost to follow up. We collected the AOFAS score preoperatively, and at three and six months. Hallux valgus angle, first-second intermetatarsal angle and sesamoid subluxation were measured from weight bearing radiographs taken preoperatively and at six weeks and six months.
Results
Total AOFAS score increased from 43.1 preoperatively to 85.0 at three months postoperatively (p< 0.0001, 95% CI of 44.5 to 35.5). The AOFAS scores at three and six months also showed significant difference (p< 0.0001, 95% CI of 4 to 10). All the components of AOFAS showed similar improvement postoperatively. The hallux valgus angle decreased from 30.1 to 9.9 degrees at six weeks post operatively (p< 0.0001, 95% CI of 22.21 to 18.27). The first-second intermetatarsal angle decreased from 12.6 to 6.4 at 6 weeks post operatively (p< 0.0001, 95% CI of 5.1 to 7.14). Sesamoid subluxation was reduced in the majority of cases. We had two fractures of the metatarsal head, three wound infections and six cases of transient neuropraxia of the cutaneous nerves.
Conclusion
With Scarf osteotomy, we achieved good correction of the hallux valgus deformity and significant improvement of AOFAS score. It is a versatile and reliable procedure in the management of hallux valgus.
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.
