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SCARF OSTEOTOMY FOR CORRECTION OF HALLUX VALGUS: CLINICAL AND PAEDOBAROGRAPHIC EVALUATION

Arrowe Park Hospital, Arrowe Park Road, Upton, Wirral L49 5PE

Scarf osteotomy is a z-osteotomy of the 1st metatarsal and is proposed to correct anatomical and functional deformities of hallux valgus. This procedure allows early ambulation and early return of function. This study was conducted to evaluate clinical and paedobarographic results following this procedure in a district general hospital.

From August 2000, we prospectively collected the data on 43 feet (32 consecutive patients) followed up for 12 months. We collected the data pre-operatively, 3,6 and 12 months post-operatively using AOFAS score, weight-bearing radiographs and paedobarographs. From the paedobarographs (Musgrave), the forefoot function was evaluated using peak pressure, force time integral and pressure time integrals.

Mean total AOFAS score increased from 45.13 pre-operatively to 94.5 post-operatively (p<0.001). Postoperatively, the hallux valgus angle decreased from 29.83° to 11.79° and 1–2 intermetatarsal angle decreased from 12.48° to 6.37° (p<0.001). Post-operatively, peak pressure has increased under the 1st metatarsal head and decreased under the 2nd metatarsal head. Force time integral and pressure time integrals also showed similar changes. We have not noticed significant alteration of forefoot pressures under the lateral part of forefoot.

Using scarf osteotomy, we achieved good correction of the hallux valgus deformity and significant improvement of AOFAS scores. We also noted alteration of the forefoot function with increased pressure under the 1st metatarsal and reduced pressure under the 2nd metatarsal head.

Conclusion: We believe that scarf osteotomy is a versatile and reliable procedure in the management of hallux valgus.

The abstracts were prepared by Mr Tim Briggs. (Editoral Secretary 2003/4) Correspondence should be addressed to him at Lane Farm, Chapel Lane, Totternhoe, Dunstable, Bedfordshire LU6 2BZ, United Kingdom