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Journal of Bone and Joint Surgery - British Volume, Vol 86-B, Issue 6,
830-836.
doi: 10.1302/0301-620X.86B6.15000 Copyright © 2004 by British Editorial Society of Bone and Joint Surgery Scarf osteotomy for hallux valgusA PROSPECTIVE CLINICAL AND PEDOBAROGRAPHIC STUDYS. Jones, FRCS (Trauma & Orth), Consultant Orthopaedic Surgeon; H. A. Al Hussainy, FRCS Ed, Orthopaedic Clinical Research Fellow; F. Ali, FRCS (Trauma & Orth), Specialist Orthopaedic Registrar; R. P. Betts, PhD, Clinical Scientist; and M. J. Flowers, FRCS Orth, Senior Consultant Orthopaedic SurgeonDepartment of Orthopaedics, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK. Correspondence should be sent to Mr S. Jones. We prospectively reviewed 24 patients (35 feet) who had been treated by a Scarf osteotomy and Akin closing-wedge osteotomy for hallux valgus between June 2000 and June 2002. There were three men and 21 women with a mean age of 46 years at the time of surgery. The mean follow-up time was 20 months. Our results showed that 50% of the patients were very satisfied, 42% were satisfied, and 8% were not satisfied. The mean American Orthopaedic Foot and Ankle Society score improved significantly from 52 points pre-operatively to 89 at follow-up (p < 0.001). The intermetatarsal and hallux valgus angles improved from the mean pre-operative values of 15° and 33° to 9° and 14°, respectively. These improvements were significant (p < 0.0001). The change in the distal metatarsal articular angle was not significant (p = 0.18). There was no significant change in the mean pedobarographic measurements of the first and second metatarsals after surgery (p = 0.2). The mean pedobarographic measurements of the first and second metatarsals at more than one year after surgery were within the normal range. Two patients had wound infections which settled after the administration of antibiotics. One patient had an intra-operative fracture of the first metatarsal and one required further surgery to remove a long distal screw which was irritating the medial sesamoids. We conclude that the Scarf osteotomy combined with the Akin closing-wedge osteotomy is safe and effective for the treatment of hallux valgus.
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