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Does preoperative deformity diminish radiographic outcome after hallux valgus correction with scarf osteotomy?: A retrospective study of 102 cases.
Foot Ankle Surg. 2020 Jun; 26(4):425-431.FA

Abstract

BACKGROUND

Scarf osteotomy is a frequently used technique to correct moderate to severe hallux valgus deformities. Recurrence of a deformity is a commonly reported complication after surgery. The aim of our study was to evaluate the impact of preoperative deformity on radiological outcome in terms of postoperative loss of correction after scarf osteotomy.

METHODS

102 patients, in which a hallux valgus deformity was corrected with an isolated scarf osteotomy were included. Weightbearing radiographs were analyzed preoperatively, postoperatively, after 6 weeks and after three months (mean 10.9 months SD 17.2 months). The following radiological parameters were used for analysis: the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA), position of the sesamoids, first metatarsal length, and first metatarsophalangeal joint congruity.

RESULTS

Significant correction of IMA, HVA, DMAA, sesamoid position and joint congruity was achieved (p < 0.001). The IMA improved from 15.8 ± 2.3 to 4.3 ± 2.8°, the HVA from 32.6 ± 6.8 to 9.1 ± 7.2, and the DMAA from 11.4 ± 6.9 to 8.4 ± 5.2°, respectively. In contrast to DMAA, throughout followup we could detect loss of correction for HVA and for IMA amounting 6.3° ± 5.8 and 3.8° ± 2.8 respectively. Loss of HVA correction revealed a significant correlation with preoperative DMAA, but not with the other preoperative radiological parameters.

CONCLUSIONS

Preoperative deformity does not correlate with postoperative loss of correction after scarf osteotomy, except DMAA.

CLINICAL RELEVANCE

Our results may be helpful in counseling patients regarding recurrence of hallux valgus deformity after scarf osteotomy.

LEVEL OF EVIDENCE

Therapeutic, Level IV, retrospective case series.

Authors+Show Affiliations

OFZ Innsbruck, Orthopedic and Foot Centre Innsbruck, Innrain 2/3. Stock, 6020, Innsbruck, Austria. Electronic address: gerhard.kaufmann9@chello.at.Institute of Patient-centered Outcome Research (IIPCOR), Dr. Stumpf Straβe 56, 6020, Innsbruck, Austria. Electronic address: johannes.giesinger@iipcor.org.Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. Electronic address: philipp.hofer@i-med.ac.at.Orthopedic Department, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. Electronic address: matthias.braito@gmail.com.Orthopedic Department, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. Electronic address: rainer.biedermann@i-med.ac.at.Orthopedic Department, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. Electronic address: dietmar.dammerer@tirol-kliniken.at.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31202526

Citation

Kaufmann, Gerhard, et al. "Does Preoperative Deformity Diminish Radiographic Outcome After Hallux Valgus Correction With Scarf Osteotomy?: a Retrospective Study of 102 Cases." Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons, vol. 26, no. 4, 2020, pp. 425-431.
Kaufmann G, Giesinger JM, Hofer P, et al. Does preoperative deformity diminish radiographic outcome after hallux valgus correction with scarf osteotomy?: A retrospective study of 102 cases. Foot Ankle Surg. 2020;26(4):425-431.
Kaufmann, G., Giesinger, J. M., Hofer, P., Braito, M., Biedermann, R., & Dammerer, D. (2020). Does preoperative deformity diminish radiographic outcome after hallux valgus correction with scarf osteotomy?: A retrospective study of 102 cases. Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons, 26(4), 425-431. https://doi.org/10.1016/j.fas.2019.05.007
Kaufmann G, et al. Does Preoperative Deformity Diminish Radiographic Outcome After Hallux Valgus Correction With Scarf Osteotomy?: a Retrospective Study of 102 Cases. Foot Ankle Surg. 2020;26(4):425-431. PubMed PMID: 31202526.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does preoperative deformity diminish radiographic outcome after hallux valgus correction with scarf osteotomy?: A retrospective study of 102 cases. AU - Kaufmann,Gerhard, AU - Giesinger,Johannes M, AU - Hofer,Philipp, AU - Braito,Matthias, AU - Biedermann,Rainer, AU - Dammerer,Dietmar, Y1 - 2019/05/27/ PY - 2018/08/11/received PY - 2019/02/25/revised PY - 2019/05/13/accepted PY - 2019/6/17/pubmed PY - 2020/11/18/medline PY - 2019/6/17/entrez KW - Hallux valgus KW - Loss of correction KW - Preoperative deformity KW - Prognostic factors KW - Radiological outcome KW - Scarf osteotomy SP - 425 EP - 431 JF - Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons JO - Foot Ankle Surg VL - 26 IS - 4 N2 - BACKGROUND: Scarf osteotomy is a frequently used technique to correct moderate to severe hallux valgus deformities. Recurrence of a deformity is a commonly reported complication after surgery. The aim of our study was to evaluate the impact of preoperative deformity on radiological outcome in terms of postoperative loss of correction after scarf osteotomy. METHODS: 102 patients, in which a hallux valgus deformity was corrected with an isolated scarf osteotomy were included. Weightbearing radiographs were analyzed preoperatively, postoperatively, after 6 weeks and after three months (mean 10.9 months SD 17.2 months). The following radiological parameters were used for analysis: the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA), position of the sesamoids, first metatarsal length, and first metatarsophalangeal joint congruity. RESULTS: Significant correction of IMA, HVA, DMAA, sesamoid position and joint congruity was achieved (p < 0.001). The IMA improved from 15.8 ± 2.3 to 4.3 ± 2.8°, the HVA from 32.6 ± 6.8 to 9.1 ± 7.2, and the DMAA from 11.4 ± 6.9 to 8.4 ± 5.2°, respectively. In contrast to DMAA, throughout followup we could detect loss of correction for HVA and for IMA amounting 6.3° ± 5.8 and 3.8° ± 2.8 respectively. Loss of HVA correction revealed a significant correlation with preoperative DMAA, but not with the other preoperative radiological parameters. CONCLUSIONS: Preoperative deformity does not correlate with postoperative loss of correction after scarf osteotomy, except DMAA. CLINICAL RELEVANCE: Our results may be helpful in counseling patients regarding recurrence of hallux valgus deformity after scarf osteotomy. LEVEL OF EVIDENCE: Therapeutic, Level IV, retrospective case series. SN - 1460-9584 UR - https://www.unboundmedicine.com/medline/citation/31202526/Does_preoperative_deformity_diminish_radiographic_outcome_after_hallux_valgus_correction_with_scarf_osteotomy:_A_retrospective_study_of_102_cases_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1268-7731(18)30338-2 DB - PRIME DP - Unbound Medicine ER -