A rotational scarf osteotomy decreases troughing when treating hallux valgus.
BACKGROUND
The traditional scarf osteotomy has been associated with complication rates between 1.1% and 45%. We have modified the traditional technique with a rotational osteotomy to reduce these complications.


OBJECTIVE
We determined whether a modified rotational scarf osteotomy improves functional outcome scores, allows correction of a wide degree of an intermetatarsal (IM) angle deformity, has a low incidence of troughing, and maintains normal ROM postoperatively in the treatment of symptomatic hallux valgus (HV).


METHODS
We retrospectively reviewed 140 patients: 38 men and 102 women with a mean age of 54 years (range, 35-66 years) who underwent surgery for HV and had a minimum followup of 24 months (mean, 41 months; range, 24-68 months). All patients had preoperative and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) forefoot and Short Form (SF)-36 V2 outcome scores recorded.


RESULTS
The mean AOFAS score improved from 52 points preoperatively to 92 points (range, 71-96 points) at followup. The mean SF-36 V2 score improved from 69 points preoperatively to 94 points (range, 67-98 points) at followup. The IM angle improved from a preoperative mean of 18° (range, 9°-23°) to a mean of 8° (range, 6°-12°). Eleven patients experienced a complication.


CONCLUSIONS
The modified rotational scarf osteotomy has a low complication rate (9%) and apparently reduces the risk of troughing. This procedure can reduce a high degree of IM angle deformity while restoring function to the forefoot.


METHODS
Level IV, case series. See Guidelines for Authors for a complete description of levels of evidence.
Department of Foot and Ankle Surgery, Hospital for Special Surgery, 523 East 72nd Street, Suite 514, New York, NY 10021, USA. murawskic@hss.edu
Christopher D
CD
Murawski
Christopher J
CJ
Egan
John G
JG
Kennedy
D000328:Adult; D000368:Aged; D005260:Female; D005545:Forefoot, Human / Q000473:pathology / Q000601:surgery*; D006215:Hallux Valgus / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000002:abnormalities / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D012399:Rotation; D018434:Sickness Impact Profile; D016896:Treatment Outcome