Scarf Osteotomy Combined with Distal Soft Tissue Realignment for Moderate to Severe Hallux Valgus

Jin Wenkuo; Sun Junsuo; Wang Tietao

Abstract：Objective To explore the efficacy and discuss the operative technique of Scarf osteotomy combined with distal soft tissue realignment for moderate to severe hallux valgus.Methods We evaluated 46 patients (49 feet) who underwent a Scarf osteotomy combined with distal soft tissue realignment.The mean duration of follow-up was 13 months in all the patients (range,10~17 months).The therapeutic effect was assessed with American Orthopaedic Foot and Ankle Society (AOFAS) before surgery and at the time of final follow-up.The hallux valgus angle(HVA) and intermetatarsal angle (IMA) were measured preoperatively,at six-week postoperative,and at the time of final follow-up.Sesamoid bone position were recorded preoperatively and at the time of final follow-up.All parameters were statistically analyzed with SPSS15.0.Results The AOFAS score improved from 50.03 points preoperatively to 87.18 points at the time of final follow-up.Mean preoperative HVA decreased from 29.43° degrees preoperatively to 12.79° degrees at the six-week postoperative and was maintained at last follow-up at 13.51° degrees.The mean IMA decreased from 15.29° degrees preoperatively to 5.74° degrees at the six-week postoperative and regressed mildly at last follow-up to 7.81° degrees and sesamoid bone position) showed significant (P<0.05) improvement at the time of final follow-up compared with preoperative.There was a mean loss of correction of the IMA of 2.07° degrees ,Although these regressions between the six-week postoperative and last follow-up radiographs were statistically significant,it did not result in functional impairment or consequences for quality of life.Conclusion Scarf osteotomy combined with distal soft tissue realignment is an ideal operative treatment for hallux valgus,can achieve a Satisfied short-term clinical outcomes.