title: Prevalence of Metatarsus Adductus in Symptomatic Hallux Valgus and Its Influence on Functional Outcome.
abstract: BACKGROUND
  Metatarsus adductus (MA) increases the risk of developing symptomatic hallux valgus (HV). This study aimed to determine the prevalence of MA in patients with symptomatic HV and to evaluate how it affected the functional outcome after scarf osteotomy.
  
  
  METHODS
  Between January 2007 and June 2012, a total of 206 patients who underwent scarf osteotomy for symptomatic HV at a tertiary hospital were included. The metatarsus adductus angle (MAA) was determined using the Modified Sgarlato method, and these patients were categorized into 2 groups: MA (MAA > 20 degrees); and Control (MAA ≤ 20 degrees). The patients were prospectively followed for 2 years.
  
  
  RESULTS
  The prevalence of MA was 33% (68/206) with a mean MAA of 24 ± 4 degrees (range = 20-39). There was a 21 ± 12 degrees and 18 ± 9 degrees improvement in hallux valgus angle for the MA and Control groups, respectively (P = .061), whereas there was a 6 ± 4 degrees and 6 ± 3 degrees improvement in intermetartarsal angle for the MA and Control groups, respectively (P = .475). The visual analog scale, AOFAS Hallux Metatarsophalangeal-Interphalangeal Scale, and Physical and Mental Component Scores were comparable between the 2 groups both preoperatively and at 2 years' follow-up (all P > .05). Two patients in the control group required revision surgery for recurrence symptomatic HV.
  
  
  CONCLUSIONS
  The authors conclude that MA did not predispose the patient to poorer functional outcome after scarf osteotomy with the advent of good operative techniques.
  
  
  METHODS
  Level II, prospective comparative study.
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, The Academia, Singapore zantesuken@hotmail.com.
authors.forename: Bryan
authors.initials: B
authors.lastname: Loh
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, The Academia, Singapore.
authors.forename: Jerry Yongqiang
authors.initials: JY
authors.lastname: Chen
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, The Academia, Singapore.
authors.forename: Andy Khye Soon
authors.initials: AK
authors.lastname: Yew
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, The Academia, Singapore.
authors.forename: Hwei Chi
authors.initials: HC
authors.lastname: Chong
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, The Academia, Singapore.
authors.forename: Malcolm Guan Hin
authors.initials: MG
authors.lastname: Yeo
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, The Academia, Singapore.
authors.forename: Peng
authors.initials: P
authors.lastname: Tao
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, The Academia, Singapore.
authors.forename: Nicholas Eng Meng
authors.initials: NE
authors.lastname: Yeo
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, The Academia, Singapore.
authors.forename: Kevin
authors.initials: K
authors.lastname: Koo
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, The Academia, Singapore.
authors.forename: Inderjeet
authors.initials: I
authors.lastname: Rikhraj Singh
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005532:Foot Deformities, Congenital / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D006215:Hallux Valgus / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008684:Metatarsus / Q000002:abnormalities*; D008875:Middle Aged; D010027:Osteotomy; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D016896:Treatment Outcome
keywords: functional outcome; hallux valgus; metatarsus adductus; repeat surgery; scarf osteotomy