Murawski, C, Egan, C, RPA-C, Kennedy, J, MD

Abstract: The traditional scarf osteotomy has been associated with complications rates between 1.1% and 45%. We have modified the traditional technique with a rotational osteotomy to reduce these complications.

Questions / purposes We determined whehter a modified rotational scarf osteotomy improves functional outcome scores, allows correction of a wide degree of an intermetatarsal (IM) angle deformity, has a low incidence of troughing, and maintains normal ROM postoperatively in the treatment of symptomatic hallux valgus (HV).

Patients and Methods: We retrospectively reviewed 140 patients; 38 men and 102 women with a mean age of 54 years (range, 35-66) who underwent surgery for HV and had a minimum followup of 24 months (mean, 41 months; range, 24-68 months). All patients had preoperative and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) forefoot and Short Form (SF)-36 V2 outcome scores recorded.

Results: The mean AOFAS score improved from 52 points preoperatively to 92 points (range, 71-96 points) at followup. The mean SF-36 V2 score improved from 69 points preoperatively to 94 points (range, 67-98 points) at followup. The IM angle improved from a preoperative mean of 18* (range, 9* – 23*) to a mean of 8* (range, 6* – 12*). Eleven patients experienced a complication.

Conclusions The modified rotational scarf osteotomy has a low complication rate (9%) and apparently reduces the risk of troughing. This procedure can reduce a high degree of IM angle deformity while restoring function to the forefoot.

Level of Evidence Level IV, case series. See Guidelines for Authors for a complete description of levels of evidence