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Scarf Osteotomy for Hallux Valgus Deformity

A Prospective Study with 8 Years of Clinical and Radiologic Follow-up

Jeroen J. K. De Vil, MD ^*, Peter Van Seymortier, MD ^*, Willem Bongaerts, MD ^*, Pieter-Jan De Roo, MD ^*, Barbara Boone, MD, PhD  and René Verdonk, MD, PhD ^*

^* Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium.
Department of Dermatology, Ghent University Hospital, Ghent, Belgium.

Corresponding author: Jeroen J. K. De Vil, MD, Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, De Pintelaan 185, Ghent, 9000, Belgium. (E-mail: jeroendevil{at}yahoo.co.uk)

Abstract

Background: Scarf midshaft metatarsal osteotomy has become increasingly popular as a treatment option for moderate-to-severe hallux valgus deformities because of its great versatility. Numerous studies on Scarf osteotomy have been published. However, no prospective studies were available until 2002. Since then, only short-term follow-up prospective studies have been published. We present the results of a prospective study of 21 patients treated by Scarf osteotomy for hallux valgus with follow-up of 8 years.

Methods: Between August 1, 1999, and October 31, 1999, 23 patients (23 feet) with moderate-to-severe hallux valgus deformity were included. Clinical (American Orthopaedic Foot and Ankle Society score) and radiologic (hallux valgus angle, first intermetatarsal angle, and sesamoid position) evaluations were performed preoperatively and 1 and 8 years postoperatively.

Results: Clinical evaluation showed a significant improvement in the mean forefoot score from 47 to 83 (of a possible 100) at 1 year (P < .001). Radiographic evaluation showed significant improvement in the hallux valgus angle (mean improvement, 19°; P < .001) and in the intermetatarsal angle (mean improvement, 6°; P < .001). These clinical and radiographic results were maintained at the final evaluation 8 years postoperatively.

Conclusions: Scarf osteotomy tends to provide predictable and sustainable correction of moderate-to-severe hallux valgus deformities. (J Am Podiatr Med Assoc 100(1): 35–40, 2010)