Abstract
The paper elaborates on scarf osteotomy in the treatment of hallux valgus deformity. The study evaluates 175 isolated scarf osteotomies of the first metatarsal (with/without the Akin procedure) performed by one surgeon. Radiological (intermetatarsal angle-IMA, hallux valgus angle-HVA, distal-metatarsal articular angle-DMAA, proximal-to-distal phalangeal-articular angle-PDPAA, translation of diaphysis and sesamoid position) and clinical (Foot and Ankle Disability Index - FADI and the American Orthopedic Foot and Ankle Score - AOFAS) evaluation was done before and after treatment. The follow-up was from 1 to 10 years. HVA decreased 24°, from 32°±8,8(16°-60°) to 8°±7,4(-27°-32°), IMA decreased 11°, from 15°±3,7(16°-31°) to 4°±2,4(0°-13°), DMAA for 12°-from 17° to 5°, PDPAA for 5°-from 5° to 0° and sesamoid position from 5(2-7) to 1(1-7). The first metatarsal translation was 58%±14,5(17%-94%). FADI enlarged from 65±18.2(26-99) to 95±9,7(45-100) and AOFAS from 76±9,to 6(47-98) 96±6,9(72-100). All diferences were significant (p<0,05). Recurrence was 4,6%, iatrogenic hallux varus 6,3%, symptomatic screw 9%, transfer metatarsalgia 2,3%, troughing 2,9% superficial wound infection 1,1%, and postoperative hypesthesia 1,1%. Scarf osteotomy is a reliable and safe procedure for the correction of moderate to severe hallux valgus deformities. A relatively long learning curve is a burden with solvable complications.