Tailor's bunion: results of a scarf osteotomy for the correction of an increased intermetatarsal IV/V angle. A report on ten cases with a 1-year follow-up.
BACKGROUND
The aim of this study was to analyze clinical and radiological results of scarf osteotomy for the correction of an increased intermetatarsal IV/V angle in patients with symptomatic tailors bunion.


METHODS
Between 1997 and 1998, we performed a scarf osteotomy for the correction of an increased intermetatarsal IV/V angle (IMA) in ten cases. The indication was a painful prominence of the fifth metatatarsal with an increased IMA. Fixation of the osteotomy was performed with two 1.7-mm titanium miniscrews. Mobilization was allowed with full weight-bearing, with a forefoot relief orthosis. Clinical results were evaluated with the forefoot scoring system (ffss). The determination of the IMA was performed with weight-bearing dorsoplantar radiographs.


RESULTS
All osteotomies healed within the first 6 postoperative weeks. Removal of the screws was not necessary in any case. The mean preoperative ffss was 29.5 points. At the last follow-up, the mean value of the ffss was 73 points and no patient presented a painful prominence above the fifth metatarsal head. The mean IMA was reduced significantly from 10.3 to 6.8 degrees.


CONCLUSIONS
The scarf osteotomy is an adequate surgical procedure for the correction of an increased IMA in patients with symptomatic tailor's bunion.
Lubinus Klinik, Hospital for Surgery and Orthopeadics, Steenbeker Weg 25, 24106 Kiel, Germany.
H W
HW
Seide
W
W
Petersen
D000328:Adult; D000368:Aged; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging* / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging* / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D010147:Pain Measurement; D011336:Probability; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016474:Weight-Bearing