Scarf osteotomy for hallux valgus deformity: Radiological outcome, metatarsal length and early complications in 118 feet.


Journal

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons
ISSN: 1460-9584
Titre abrégé: Foot Ankle Surg
Pays: France
ID NLM: 9609647

Informations de publication

Date de publication:
Jan 2021
Historique:
received: 18 06 2019
revised: 25 11 2019
accepted: 03 01 2020
pubmed: 26 1 2020
medline: 11 5 2021
entrez: 26 1 2020
Statut: ppublish

Résumé

Scarf osteotomy has been widely used to restore axial orientation of the first ray in the treatment of hallux valgus deformity. The aim of the study was to present our radiological outcomes of bunion reconstruction, identify surgical complications in early follow-up, and assess to what extent a shortening of the first metatarsal is present after surgery as a possible cause of postoperative metatarsalgia. We enrolled 106 patients (118 feet) and assessed patients' pre- and postoperative measurements of hallux valgus and intermetatarsal angles on weightbearing X-ray images. Three different methods of measuring metatarsal length were compared and early postoperative complications noted. Hallux valgus angle decreased significantly by an average of 18.7 degrees and the intermetatarsal angle by 7.8 degrees. Using three methods of measuring metatarsal length, all showed significant shortening of the first metatarsal. Mean relative lengthening of the second metatarsal averaged 0.45mm. The Coughlin method showed the highest interrater reliability (ICC=0.96). Significant reduction of the hallux valgus angle and intermetatarsal angle was demonstrated with a low complication rate. There was significant shortening of the first metatarsal. The Coughlin method clearly demonstrated an excellent interrater reliability. Level IV.

Sections du résumé

BACKGROUND BACKGROUND
Scarf osteotomy has been widely used to restore axial orientation of the first ray in the treatment of hallux valgus deformity. The aim of the study was to present our radiological outcomes of bunion reconstruction, identify surgical complications in early follow-up, and assess to what extent a shortening of the first metatarsal is present after surgery as a possible cause of postoperative metatarsalgia.
METHODS METHODS
We enrolled 106 patients (118 feet) and assessed patients' pre- and postoperative measurements of hallux valgus and intermetatarsal angles on weightbearing X-ray images. Three different methods of measuring metatarsal length were compared and early postoperative complications noted.
RESULTS RESULTS
Hallux valgus angle decreased significantly by an average of 18.7 degrees and the intermetatarsal angle by 7.8 degrees. Using three methods of measuring metatarsal length, all showed significant shortening of the first metatarsal. Mean relative lengthening of the second metatarsal averaged 0.45mm. The Coughlin method showed the highest interrater reliability (ICC=0.96).
CONCLUSIONS CONCLUSIONS
Significant reduction of the hallux valgus angle and intermetatarsal angle was demonstrated with a low complication rate. There was significant shortening of the first metatarsal. The Coughlin method clearly demonstrated an excellent interrater reliability.
LEVEL OF EVIDENCE METHODS
Level IV.

Identifiants

pubmed: 31980384
pii: S1268-7731(20)30004-7
doi: 10.1016/j.fas.2020.01.002
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

20-24

Informations de copyright

Copyright © 2020 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Auteurs

Christopher G Lenz (CG)

Cantonal Hospital Baden, Department of Orthopaedics and Traumatology, Im Ergel 1, 5404 Baden, Switzerland. Electronic address: christopher.lenz@ksb.ch.

Richard Niehaus (R)

Cantonal Hospital Baden, Department of Orthopaedics and Traumatology, Im Ergel 1, 5404 Baden, Switzerland.

Ivo Knych (I)

Cantonal Hospital Baden, Department of Orthopaedics and Traumatology, Im Ergel 1, 5404 Baden, Switzerland.

Karim Eid (K)

Cantonal Hospital Baden, Department of Orthopaedics and Traumatology, Im Ergel 1, 5404 Baden, Switzerland.

Paul Borbas (P)

Cantonal Hospital Baden, Department of Orthopaedics and Traumatology, Im Ergel 1, 5404 Baden, Switzerland.

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Classifications MeSH