Postoperative Hallux Varus Treatment by Reverse Scarf Osteotomy.
hallux varus
iatrogenic deformity
intermetatarsal angle
reverse scarf osteotomy
Journal
Foot & ankle international
ISSN: 1944-7876
Titre abrégé: Foot Ankle Int
Pays: United States
ID NLM: 9433869
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
pubmed:
20
4
2021
medline:
26
10
2021
entrez:
19
4
2021
Statut:
ppublish
Résumé
Postoperative hallux varus is often accompanied by an abnormal decrease in the first-second (M1M2) intermetatarsal angle, which we have sought to correct by a reverse scarf-type osteotomy. A series of 36 hallux varus operated on by reverse scarf osteotomy, including 14 with prior osteotomies, was reviewed with an average follow-up of 56 months. The measurements were clinical: American Orthopaedic Foot & Ankle Society (AOFAS) score, visual analog scale (VAS) pain score, subjective satisfaction index, joint mobility, and radiologic angles: M1M2 and first metatarsophalangeal angle. The M1M2 angle increased on average from 3 to 8 degrees whereas the average M1P1 angle of varus went from -21 to +9 degrees, including 2 patients who had a reoccurring valgus of 20 degrees. The median AOFAS score increased from 47 to 79, the VAS from 6.7 to 2.3, joint mobility lost an average of 9 degrees, and all those operated on were satisfied with the result. All operated bones healed without secondary displacement. The reverse scarf osteotomy is capable of correcting the intermetatarsal angle and at the same time correcting the postoperative hallux varus. Functional scores generally improved, including in patients with a reoccurring valgus and those with reduced mobility. The reverse scarf osteotomy can be performed to treat postoperative hallux varus with a mild intermetatarsal angle with reasonable clinical and radiologic results. Level III, retrospective cohort study.
Sections du résumé
BACKGROUND
BACKGROUND
Postoperative hallux varus is often accompanied by an abnormal decrease in the first-second (M1M2) intermetatarsal angle, which we have sought to correct by a reverse scarf-type osteotomy.
METHODS
METHODS
A series of 36 hallux varus operated on by reverse scarf osteotomy, including 14 with prior osteotomies, was reviewed with an average follow-up of 56 months. The measurements were clinical: American Orthopaedic Foot & Ankle Society (AOFAS) score, visual analog scale (VAS) pain score, subjective satisfaction index, joint mobility, and radiologic angles: M1M2 and first metatarsophalangeal angle.
RESULTS
RESULTS
The M1M2 angle increased on average from 3 to 8 degrees whereas the average M1P1 angle of varus went from -21 to +9 degrees, including 2 patients who had a reoccurring valgus of 20 degrees. The median AOFAS score increased from 47 to 79, the VAS from 6.7 to 2.3, joint mobility lost an average of 9 degrees, and all those operated on were satisfied with the result. All operated bones healed without secondary displacement.
DISCUSSION
CONCLUSIONS
The reverse scarf osteotomy is capable of correcting the intermetatarsal angle and at the same time correcting the postoperative hallux varus. Functional scores generally improved, including in patients with a reoccurring valgus and those with reduced mobility.
CONCLUSION
CONCLUSIONS
The reverse scarf osteotomy can be performed to treat postoperative hallux varus with a mild intermetatarsal angle with reasonable clinical and radiologic results.
LEVEL OF EVIDENCE
METHODS
Level III, retrospective cohort study.
Identifiants
pubmed: 33870737
doi: 10.1177/10711007211001027
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM