Mid-term results of Scarf osteotomy in hallux valgus.
We performed a retrospective study on 178 Scarf osteotomies with a mean follow-up of 44.9 months (range 15-83 months). Clinical rating was based on the forefoot score of the American Orthopaedic Foot and Ankle Society (AOFAS). Weight bearing X-rays were used to perform angular measurements and assess the first metatarsophalangeal joint (MTP 1). At follow-up the mean AOFAS score had improved significantly (p < 0.001), but only 55% of the feet showed a perfect realignment of the first ray. Patients with a hallux valgus angle exceeding 30° and pre-existing degenerative changes at the MTP 1 joint displayed inferior clinical results (p < 0.05). Nearly 20% of the patients suffered from pain at the MTP 1 joint. This was clearly attributed to an onset or worsening of distinct radiographic signs of arthritis (p < 0.05) resulting in painfully decreased joint motion. Comparing radiographic appearance three months postoperatively and at follow-up, we found that radiographic criteria (hallux valgus, first intermetatarsal angle, hallux valgus interphalangeus, MTP 1 joint congruency, arthritic lesions at MTP 1) worsened with time.
Department of Orthopaedic Surgery, Rudolf-Elle-Hospital, University of Jena, Klosterlausnitzerstr. 81, Eisenberg, Germany. RAEFuhrmann@aol.com
Renée A
RA
Fuhrmann
Hans
H
Zollinger-Kies
Hans-Peter
HP
Kundert
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007593:Joint Instability; D008297:Male; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D010149:Postoperative Pain / Q000209:etiology / Q000503:physiopathology; D011183:Postoperative Complications; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult