Scarf and Akin osteotomies for moderate and severe hallux valgus: clinical and radiographic results.
BACKGROUND
The scarf and the combined scarf-Akin procedures are reliable therapeutic tools and can obtain effective correction of symptomatic moderate to severe hallux valgus deformities.


METHODS
The data from 30 patients (37 feet) with moderate to severe hallux valgus deformity who had scarf osteotomies have been retrospectively reviewed. 32 Akin and 77 Weil osteotomies were also carried out at the same stage. The average follow-up was 22 months. Standardized methods of radiographic and clinical data collection were obtained before and after surgery. Patient satisfaction was assessed at follow-up.


RESULTS
Radiological assessment revealed a significant improvement (p<0.001) of the hallux valgus angle (mean reduction 17.4 degrees), the intermetatarsal angle (mean reduction 5.8 degrees), the medial sesamoid position (14% of the feet were grade 1 or less preoperatively and this rate increased to 84% at follow-up) and the DMAA (mean reduction 9 degrees). The complication rate was 19%. Clinical improvement was achieved with the AOFAS score increasing from 46 to 86 points (p<0.001).


CONCLUSIONS
We conclude that the procedure has value in obtaining predictable correction of moderate to severe hallux valgus deformities.
Garrido
Ignacio Martínez
IM
Department of Orthopaedics, La Fe Hospital, University of Valencia, Valencia, Spain. nmg17545@yahoo.es
Rubio
Eduardo Rodríguez-Vellando
ER
Bosch
Marta Navarro
MN
González
María Sánchez
MS
Paz
Guillermo Bastida
GB
Llabrés
Alfredo Juan
AJ
D000328:Adult; D000368:Aged; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D012720:Severity of Illness Index