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Effectiveness of Headless Bioabsorbable Screws for Fixation of the Scarf Osteotomy.
Foot Ankle Int. 2016 Nov; 37(11):1189-1196.FA

Abstract

BACKGROUND

Scarf osteotomy has been used in hallux valgus surgery due to its large fixation surface for screws and low postoperative complications. However, screws may cause skin irritation from their head, which may require an additional surgical procedure to remove.

METHODS

This study included 115 patients (106 females and 9 males, 115 feet) who underwent hallux valgus correction with a scarf osteotomy using bioabsorbable screws between September 2010 and September 2012. Preoperative and postoperative 1-month and 1-year radiographic measurements, including intermetatarsal angle (IMA), hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), proximal phalangeal articular angle (PPAA), and lateral translational distance (LTD), were obtained. American Orthopaedic Foot & Ankle Society (AOFAS) hallux/forefoot scores were used for patient satisfaction.

RESULTS

Preoperative mean values of HVA, IMA, and PPA of 32.8 degrees, 14.6 degrees, and 7.52 degrees, respectively, improved to 10.7 degrees, 6.0 degrees, and 4.6 degrees, respectively at 1-year follow up (P < .05). The difference in LTD between the 1-month and 1-year follow-up was not statistically significant. AOFAS hallux/forefoot score improved from 69.1 to 96.1 at the 1-year follow up (P < .001). Complete screw absorption was not seen radiographically. Sixteen feet had complications reported. One patient complained of skin irritation over a small protrusion of the screw, and another patient had a foreign body reaction. There were 3 patients with neurologic injury from a popliteal block and 3 patients with dorsal cutaneous nerve symptoms. Four feet had metatarsal fracture during surgery.

CONCLUSION

We found the scarf osteotomy using bioabsorbable screws to have satisfactory clinical and radiographic results with a low complication rate.

LEVEL OF EVIDENCE

Level IV, case series.

Authors+Show Affiliations

Surgery of Foot and Ankle, CM chungmu general hospital, Yeongdeuon-po, Seoul, Republic of Korea.Surgery of Foot and Ankle, Eulji Medical Center, College of Medicine, Eulji University, Seoul, Republic of Korea part4uos@naver.com.Surgery of Foot and Ankle, Eulji Medical Center, College of Medicine, Eulji University, Seoul, Republic of Korea.Surgery of Foot and Ankle, Eulji Medical Center, College of Medicine, Eulji University, Seoul, Republic of Korea.Surgery of Foot and Ankle, Eulji Medical Center, College of Medicine, Eulji University, Seoul, Republic of Korea.KT Lee's Orthopedic Hospital, Seoul, Republic of Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27672017

Citation

Kim, Jin Su, et al. "Effectiveness of Headless Bioabsorbable Screws for Fixation of the Scarf Osteotomy." Foot & Ankle International, vol. 37, no. 11, 2016, pp. 1189-1196.
Kim JS, Cho HK, Young KW, et al. Effectiveness of Headless Bioabsorbable Screws for Fixation of the Scarf Osteotomy. Foot Ankle Int. 2016;37(11):1189-1196.
Kim, J. S., Cho, H. K., Young, K. W., Lee, S. Y., Kim, J. S., & Lee, K. (2016). Effectiveness of Headless Bioabsorbable Screws for Fixation of the Scarf Osteotomy. Foot & Ankle International, 37(11), 1189-1196.
Kim JS, et al. Effectiveness of Headless Bioabsorbable Screws for Fixation of the Scarf Osteotomy. Foot Ankle Int. 2016;37(11):1189-1196. PubMed PMID: 27672017.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of Headless Bioabsorbable Screws for Fixation of the Scarf Osteotomy. AU - Kim,Jin Su, AU - Cho,Hun Ki, AU - Young,Ki Won, AU - Lee,Sang Young, AU - Kim,Ji Soo, AU - Lee,Kyoungtae, Y1 - 2016/09/25/ PY - 2016/11/5/pubmed PY - 2017/8/8/medline PY - 2016/9/28/entrez KW - fixation device KW - hallux valgus KW - scarf osteotomy SP - 1189 EP - 1196 JF - Foot & ankle international JO - Foot Ankle Int VL - 37 IS - 11 N2 - BACKGROUND: Scarf osteotomy has been used in hallux valgus surgery due to its large fixation surface for screws and low postoperative complications. However, screws may cause skin irritation from their head, which may require an additional surgical procedure to remove. METHODS: This study included 115 patients (106 females and 9 males, 115 feet) who underwent hallux valgus correction with a scarf osteotomy using bioabsorbable screws between September 2010 and September 2012. Preoperative and postoperative 1-month and 1-year radiographic measurements, including intermetatarsal angle (IMA), hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), proximal phalangeal articular angle (PPAA), and lateral translational distance (LTD), were obtained. American Orthopaedic Foot & Ankle Society (AOFAS) hallux/forefoot scores were used for patient satisfaction. RESULTS: Preoperative mean values of HVA, IMA, and PPA of 32.8 degrees, 14.6 degrees, and 7.52 degrees, respectively, improved to 10.7 degrees, 6.0 degrees, and 4.6 degrees, respectively at 1-year follow up (P < .05). The difference in LTD between the 1-month and 1-year follow-up was not statistically significant. AOFAS hallux/forefoot score improved from 69.1 to 96.1 at the 1-year follow up (P < .001). Complete screw absorption was not seen radiographically. Sixteen feet had complications reported. One patient complained of skin irritation over a small protrusion of the screw, and another patient had a foreign body reaction. There were 3 patients with neurologic injury from a popliteal block and 3 patients with dorsal cutaneous nerve symptoms. Four feet had metatarsal fracture during surgery. CONCLUSION: We found the scarf osteotomy using bioabsorbable screws to have satisfactory clinical and radiographic results with a low complication rate. LEVEL OF EVIDENCE: Level IV, case series. SN - 1944-7876 UR - https://www.unboundmedicine.com/medline/citation/27672017/Effectiveness_of_Headless_Bioabsorbable_Screws_for_Fixation_of_the_Scarf_Osteotomy_ L2 - https://journals.sagepub.com/doi/10.1177/1071100716661826?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -