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Scarf Osteotomy for Correction of Hallux Valgus Deformity in Adolescents.
Orthop Surg. 2019 Oct; 11(5):873-878.OS

Abstract

OBJECTIVE

To report the radiological and clinical outcomes of the modified scarf osteotomy for the treatment of hallux valgus deformity in adolescents.

METHODS

This retrospective study analyzed 21 patients (31 feet) who underwent a modified scarf osteotomy for correcting juvenile hallux valgus deformity between March 2015 and January 2017. There were 3 male (3 feet) and 18 female (28 feet) patients. The average age at the time of surgery was 28.6 years (range, 20-35). Patients were postoperatively followed up in the outpatient department for 12-18 months. Clinical and radiological assessments were performed preoperatively and postoperatively at 1 year. Moreover, postoperative complications were recorded. Statistical analyses for differences between preoperative and postoperative values were performed.

RESULTS

All the 21 patients were postoperatively followed up for 12-18 months, with an average of 13.2 ± 2.5 months. Clinical assessment showed that the American Orthopaedic Foot and Ankle Society score was increased from preoperative 58.0 ± 5.8 to postoperative 94.2 ± 6.6 points, respectively, and the visual analog scale score was remarkably decreased from preoperative 6.0 ± 2.0 to postoperative 1.5 ± 2.0 points at 1 year follow-up. Further radiological assessment showed that the hallux valgus angle was 37.5° ± 9.2°, 14.1° ± 6.5°, and 14.5° ± 6.5° before surgery, half a year after surgery, and 1 year after surgery, respectively; the intermetatarsal angle was 14.1° ± 4.4°, 4.8° ± 3.2°, and 5.5° ± 4.9°, respectively; and the distal metatarsal articular angle was 31.0° ± 3.5°, 7.2° ± 2.3°, and 7.5° ± 2.1°, respectively. They were significantly improved at half a year after surgery and 1 year after surgery compared to those before surgery. Complications occurred in two patients (9.5%) who had numbness on the skin of the edge of the medial incision, and the symptoms were relieved after 10 months. There was no clinical recurrence in all patients. One of the 31 feet had hallux varus, which was corrected in a second operation. Notably, a postoperative radiograph of a typical case whose both feet had hallux valgus deformity and underwent modified scarf osteotomy and additional Akin osteotomy showed adequate correction of the hallux valgus angle (HVA, 11°), intermetatarsal angle (IMA, 6°), and distal metatarsal articular angle (DMAA, 8°) on left foot compared to preoperative HVA (28°), IMA (13°), and DMAA (35°).

CONCLUSION

The modified scarf osteotomy can effectively correct the adolescent hallux valgus deformity, which is worth popularizing.

Authors+Show Affiliations

Department of Foot and Ankle Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.Department of Prevention and Health Care, Ninth Hospital of Xi'an, Xi'an, China.Department of Foot and Ankle Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.Department of Foot and Ankle Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.Department of Foot and Ankle Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.Department of Foot and Ankle Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.Department of Foot and Ankle Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31663288

Citation

Wang, Xin-Wen, et al. "Scarf Osteotomy for Correction of Hallux Valgus Deformity in Adolescents." Orthopaedic Surgery, vol. 11, no. 5, 2019, pp. 873-878.
Wang XW, Wen Q, Li Y, et al. Scarf Osteotomy for Correction of Hallux Valgus Deformity in Adolescents. Orthop Surg. 2019;11(5):873-878.
Wang, X. W., Wen, Q., Li, Y., Liu, C., Zhao, K., Zhao, H. M., & Liang, X. J. (2019). Scarf Osteotomy for Correction of Hallux Valgus Deformity in Adolescents. Orthopaedic Surgery, 11(5), 873-878. https://doi.org/10.1111/os.12539
Wang XW, et al. Scarf Osteotomy for Correction of Hallux Valgus Deformity in Adolescents. Orthop Surg. 2019;11(5):873-878. PubMed PMID: 31663288.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Scarf Osteotomy for Correction of Hallux Valgus Deformity in Adolescents. AU - Wang,Xin-Wen, AU - Wen,Qian, AU - Li,Yi, AU - Liu,Cheng, AU - Zhao,Kai, AU - Zhao,Hong-Mou, AU - Liang,Xiao-Jun, PY - 2019/03/03/received PY - 2019/08/09/revised PY - 2019/08/19/accepted PY - 2019/10/31/entrez PY - 2019/10/31/pubmed PY - 2020/3/20/medline KW - Adolescent KW - Hallux Valgus KW - Osteotomy SP - 873 EP - 878 JF - Orthopaedic surgery JO - Orthop Surg VL - 11 IS - 5 N2 - OBJECTIVE: To report the radiological and clinical outcomes of the modified scarf osteotomy for the treatment of hallux valgus deformity in adolescents. METHODS: This retrospective study analyzed 21 patients (31 feet) who underwent a modified scarf osteotomy for correcting juvenile hallux valgus deformity between March 2015 and January 2017. There were 3 male (3 feet) and 18 female (28 feet) patients. The average age at the time of surgery was 28.6 years (range, 20-35). Patients were postoperatively followed up in the outpatient department for 12-18 months. Clinical and radiological assessments were performed preoperatively and postoperatively at 1 year. Moreover, postoperative complications were recorded. Statistical analyses for differences between preoperative and postoperative values were performed. RESULTS: All the 21 patients were postoperatively followed up for 12-18 months, with an average of 13.2 ± 2.5 months. Clinical assessment showed that the American Orthopaedic Foot and Ankle Society score was increased from preoperative 58.0 ± 5.8 to postoperative 94.2 ± 6.6 points, respectively, and the visual analog scale score was remarkably decreased from preoperative 6.0 ± 2.0 to postoperative 1.5 ± 2.0 points at 1 year follow-up. Further radiological assessment showed that the hallux valgus angle was 37.5° ± 9.2°, 14.1° ± 6.5°, and 14.5° ± 6.5° before surgery, half a year after surgery, and 1 year after surgery, respectively; the intermetatarsal angle was 14.1° ± 4.4°, 4.8° ± 3.2°, and 5.5° ± 4.9°, respectively; and the distal metatarsal articular angle was 31.0° ± 3.5°, 7.2° ± 2.3°, and 7.5° ± 2.1°, respectively. They were significantly improved at half a year after surgery and 1 year after surgery compared to those before surgery. Complications occurred in two patients (9.5%) who had numbness on the skin of the edge of the medial incision, and the symptoms were relieved after 10 months. There was no clinical recurrence in all patients. One of the 31 feet had hallux varus, which was corrected in a second operation. Notably, a postoperative radiograph of a typical case whose both feet had hallux valgus deformity and underwent modified scarf osteotomy and additional Akin osteotomy showed adequate correction of the hallux valgus angle (HVA, 11°), intermetatarsal angle (IMA, 6°), and distal metatarsal articular angle (DMAA, 8°) on left foot compared to preoperative HVA (28°), IMA (13°), and DMAA (35°). CONCLUSION: The modified scarf osteotomy can effectively correct the adolescent hallux valgus deformity, which is worth popularizing. SN - 1757-7861 UR - https://www.unboundmedicine.com/medline/citation/31663288/Scarf_Osteotomy_for_Correction_of_Hallux_Valgus_Deformity_in_Adolescents_ L2 - https://doi.org/10.1111/os.12539 DB - PRIME DP - Unbound Medicine ER -