Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
권호 표지

Scarf Osteotomy for the Treatment of Recurred Hallux Valgus

재발한 무지 외반증의 치료로 시행한 Scarf 절골술

  • Nam, Il Hyun (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Ahn, Gil Yeong (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Moon, Gi Hyuk (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Lee, Yeong Hyeon (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Choi, Seong Pil (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Jeong, Taeg Young (Department of Orthopedic Surgery, Pohang St. Mary's Hospital)
  • 남일현 (포항성모병원 정형외과) ;
  • 안길영 (포항성모병원 정형외과) ;
  • 문기혁 (포항성모병원 정형외과) ;
  • 이영현 (포항성모병원 정형외과) ;
  • 최성필 (포항성모병원 정형외과) ;
  • 정택영 (포항성모병원 정형외과)
  • Received : 2013.10.15
  • Accepted : 2013.11.12
  • Published : 2013.12.15
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Recurrence is one of the most common complications after primary correction for hallux valgus deformities. The purpose of this study was to evaluate the usefulness of Scarf osteotomy with axial decompression in the treatment of recurrent hallux valgus. Materials and Methods: From April 2006 to April 2011, 14 cases (12 patients) of recurrent hallux valgus were managed with shortening Scarf osteotomy. Preoperative and postoperative radiographs were reviewed for the measurement of the hallux valgus angle (HVA), intermetatarsal angle (IMA), and the amount of the $1^{st}$ metatarsal shortening. Clinical outcomes including the visual analogue scale (VAS), the AOFAS score, and the range of motion [ROM] of the 1st metatarsophalangeal (MTP) joint were evaluated. Results: The mean HVA decreased from 27.9 degrees to 5.2 and the mean IMA decreased from 12.9 to 3.4. The mean VAS improved from 5.3 to 0.3 and the mean AOFAS score improved from 41 to 90. The mean amount of the 1st metatarsal shortening was 3.4 mm (2-5). The mean ROM of the $1^{st}$ MTP joint improved from 22 degrees (15-35) to 68 (55-75). Conclusion: Scarf osteotomy associated with axial decompression can be a useful revision procedure for the treatment of recurrent hallux valgus deformity.

Keywords

References

  1. Duan X and Kadakia AR. Salvage of recurrence after failed surgical treatment of hallux valgus. Arch Orthop Trauma Surg. 2012;132:477-85. https://doi.org/10.1007/s00402-011-1447-6
  2. Bock P, Lanz U, Kroner A, Grabmeier G and Engel A. The Scarf osteotomy: a salvage procedure for recurrent hallux valgus in selected cases. Clin Orthop Relat Res. 2010;468:2177-87. https://doi.org/10.1007/s11999-010-1363-z
  3. Robinson AH and Limbers JP. Modern concepts in the treatment of hallux valgus. J Bone Joint Surg Br. 2005; 87:1038-45. https://doi.org/10.2106/JBJS.D.02060
  4. Coughlin MJ, Mann RA, Saltzman CL. Surgery of the Foot and Ankle. 8th ed. Philadelphia:Mosby; 2007. 183-362.
  5. Coughlin MJ and Mann RA. Arthrodesis of the first metatarsophalangeal joint as salvage for the failed Keller procedure. J Bone Joint Surg Am. 1987;69:68-75. https://doi.org/10.2106/00004623-198769010-00012
  6. Grimes JS and Coughlin MJ. First metatarsophalangeal joint arthrodesis as a treatment for failed hallux valgus surgery. Foot Ankle Int. 2006;27:887-93. https://doi.org/10.1177/107110070602701104
  7. Kitaoka HB and Patzer GL. Arthrodesis versus resection arthroplasty for failed hallux valgus operations. Clin Orthop Relat Res. 1998:208-14.
  8. Machacek F, Jr., Easley ME, Gruber F, Ritschl P and Trnka HJ. Salvage of a failed Keller resection arthroplasty. J Bone Joint Surg Am. 2004;86-A:1131-8.
  9. Vienne P, Sukthankar A, Favre P, Werner CM, Baumer A and Zingg PO. Metatarsophalangeal joint arthrodesis after failed Keller-Brandes procedure. Foot Ankle Int. 2006;27:894-901. https://doi.org/10.1177/107110070602701105
  10. Wu KK. First metatarsophalangeal fusion in the salvage of failed hallux abducto valgus operations. J Foot Ankle Surg. 1994;33:383-95.
  11. Coetzee JC, Resig SG, Kuskowski M and Saleh KJ. The Lapidus procedure as salvage after failed surgical treatment of hallux valgus: a prospective cohort study. J Bone Joint Surg Am. 2003;85-A:60-5.
  12. Kitaoka HB and Patzer GL. Salvage treatment of failed hallux valgus operations with proximal first metatarsal osteotomy and distal soft-tissue reconstruction. Foot Ankle Int. 1998;19:127-31. https://doi.org/10.1177/107110079801900302
  13. Coetzee JC, Resig SG, Kuskowski M and Saleh KJ. The Lapidus procedure as salvage after failed surgical treatment of hallux valgus. Surgical technique. J Bone Joint Surg Am. 2004;86-A Suppl 1:30-6.