Lengthening scarf osteotomy for recurrent hallux valgus.
BACKGROUND
We describe using the scarf osteotomy to correct a recurrent hallux valgus deformity and lengthen the shortened first metatarsal in symptomatic iatrogenic first brachymetatarsia.


METHODS
Thirty-six lengthening scarf osteotomies were undertaken in 31 patients. Clinical and radiographic measures were taken pre and postoperatively.


RESULTS
Mean age at presentation was 53.4 years, and mean followup 3.9 years. The mean lengthening achieved was 4.9mm. All osteotomies united with no complications. The mean IMA reduction was 4.0° (p<0.001) and HVA 13.0° (p<0.001). The mean AOFAS score increase was 33.8 (p<0.001). There was a positive trend but no correlation (r=0.28) between amount of metatarsal lengthening and AOFAS score change.


CONCLUSIONS
We describe the largest lengthening scarf osteotomy series for recurrent hallux valgus with iatrogenic first brachymetatarsia. The results suggest the procedure is successful, with a low complication rate. We anticipate that restoring first metatarsal length and alignment may reduce biomechanical transfer metatarsalgia over time.
Eastbourne District General Hospital, East Sussex, UK. Electronic address: barryrose@doctors.org.uk.
Barry
B
Rose
Eastbourne District General Hospital, East Sussex, UK.
Nicholas
N
Bowman
Eastbourne District General Hospital, East Sussex, UK.
Huw
H
Edwards
Eastbourne District General Hospital, East Sussex, UK.
Samuel S
SS
Rajaratnam
Eastbourne District General Hospital, East Sussex, UK.
Andrew R
AR
Armitage
Eastbourne District General Hospital, East Sussex, UK.
Andrew D
AD
Skyrme
D000328:Adult; D000368:Aged; D005260:Female; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D012008:Recurrence
Bone lengthening; Hallux valgus; Metatarsalgia; Osteotomy