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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2008 February;59(1):15-20
Surgical treatment of hallux valgus with Scarf osteotomy
Sabatino C., Fino A., Basso M., Viglierchio P., Zoccolan A., Torasso G.
Dipartimento di Scienze Cliniche e Biologiche Clinica Ortopedica Università degli Studi di Torino
Ospedale San Luigi Gonzaga, Orbassano, Torino
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 metatarsus-phalangeal joint limiting patient’s daily activities, radiographical values of MFI, intermetatarsal (IM), proximal articular set angle (PASA) and DASA angles more than respectively 15°, 12°, 8° and 8° 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°, the MF1 angle dropped from 39.8° to 14.7°, the PASA from 16.3° to 6.8° and the DASA from 16.9° to 5.4°. 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 hallux valgus results versatile, suitable and safe with a rapid return to normal daily activity. The rate of complications detected, reflect data reported in literature.