Surgical treatment of hallux valgus with scarf osteotomy

Aim. The aim of the study was to assess the clinical and radiographical outcomes after Scarf and eventually Akin osteotomies in patients suffering from hallux valgus. Methods. Between 1 February 2000 and 31 March 2007, 139 feet (127 patients, 12 bilaterally) were treated at the San Luigi Hospital Orthopedic Clinic in Orbassano (Turin, Italy), 51 with only Scarf osteotomy, 88 in association with Akin. The average follow-up was 32 months (min 4, max 60); there were 111 women and 16 men with an average age of 52.5 years (min 27, max 78). Inclusion criteria for the surgery were pain at the first metatarsusphalangeal joint limiting patient's daily activities, radiographical values of MFI, intermetatarsal (IM), proximal articular set angle (PASA) and DASA angles more than respectively 15 degrees, 12 degrees, 8 degrees and 8 degrees in the dorso-plantar view. During the follow-up patients have been evaluated with the same radiographical angles and following the Groulier outlines giving each of them a score after the surgery. Results. Radiographically the mean IM angle preoperative value of 15.8 decreased to 10.4 degrees, the MF1 angle dropped from 39.8 degrees to 14.7 degrees, the PASA from 16.3 degrees to 6.8 degrees and the DASA from 16.9 degrees to 5.4 degrees. Clinically, following the Groulier score, in 66.7% of patients the outcomes of surgery was excellent, in 27.8% good, in 3.5% accettable, in 2% bad, with a mean score of 61.6. The most evident complications detected were rappresented by 3 patients with varus hallux after surgery and 6 with loss of correction. Conclusion. The type of corrective operation used to treat haflux valgus results versatile, suitable and safe with a rapid return to normal daily activity. The rate of complications detected, reflect data reported in literature.