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MINI FRAGMENT SCREW FIXATION OF SCARF OSTEOTOMY



Abstract

Introduction: Various techniques are being currently used for the internal fixation of scarf osteotomies. We conducted a prospective study on 23 consecutive cases of hallux valgus treated with scarf osteotomy, which was internally fixed with AO mini fragment screws. The aim of our study was to evaluate the clinical efficacy of the AO mini fragment screws in these cases.

Method: Sixteen women and one man (twenty three feet) were included in our study. Mean age was 46 years at the time of surgery. The mean follow-up time was 18 months. A single surgeon performed surgery. Patients were assessed by clinical and radiological evaluation. Preoperative and postoperative American Orthopaedic Foot and Ankle Society score was obtained.

Results: All the osteotomies united without any failure of fixation or hard ware problems. One patient developed superficial wound infection, which responded to antibiotics. At the time of follow-up all the patients were very satisfied. The mean AOFAS score improved significantly from 55 points pre-operatively to 91.95 at follow-up (p < 0.001). The intermetatarsal and hallux valgus angles improved from the mean pre-operative values of 15.86° and 31.18 degrees to 9.09° and 15.18°, respectively. These improvements were significant (p < 0.0001).

Conclusion: We report no failure of fixation in our series and conclude that this is a safe and simple technique. It is cost effective, provides stable fixation and maintains correction till the union of osteotomy.

Correspondence should be addressed to: D. Singh, BOFAS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.