The scarf osteotomy for the correction of hallux valgus deformities k. Scarf osteotomy of the first metatarsal hallux valgus. The steps for the short scarf osteotomy are identical to the standard long scarf. Scarf osteotomy was described early in the twentieth. The first utilized a rotational scarf with akin osteotomy while the other utilized a proximal chevron osteotomy. Longterm followup of a randomized controlled trial. Hallux valgus, metatarsal osteotomy, scarf osteotomy. Persistent postoperative pronation has been shown to increase deformity recurrence and have worse functional outcomes. For this reason, i dont agree with a short osteotomy when it is performed in every case by certain authors like zygmunt et al. The scarf osteotomy has gained popularity as treatment of choice in parts of europe and is based on sound structural principles. Z lengthening of the short and long extensor tendons was. Modified scarf osteotomy for treatment of hallux valgus by saad r. Surgery for a bunion may be advised if simple measures, such as wellfitting shoes, simple painkillers and padding do not relieve the discomfort of the bunion.
It allowed good realignment of the first mtp joint without the need for lesser metatarsal surgery to reduce the metatarsus adductus. It is known to have few complications and a low rate of recurrence of the bunion. A retrospective analysis of patients who underwent scarf osteotomy between 2007 and 20 was conducted. The scarf osteotomy is a wellestablished surgical method for correcting a hallux valgus deformity. Short and longterm outcomes following halluxvalgus.
In the series of adam et al however, recurrence occurred in only 2 of 34 feet after scarf osteotomy 1. The osteotomy is usually just over half the length of the metatarsal. Scarf osteotomy for correction of hallux valgus deformity. The proximal rotational metatarsal osteotomy promo technique reliably corrects pronation and varus through a stable osteotomy, avoiding fusing any healthy joints. We combined a short scarf osteotomy with an akin procedure of the proximal phalanx through a short incision with minimal soft tissue dissection, use of few metal works at the same time preserving all the advantages of a long scarf osteotomy with good clinical, radiological, and functional outcomes at 3year followup. Scarf osteotomy without internal fixation to correct hallux valgus em. The purpose of this study was to analyze the radiological outcome after scarf osteotomy in dependence of additional akin osteotomy.
The distal soft tissue procedure was performed in all cases after the. Future studies should focus on incorporating different anatomical parameters into geometric formula and to predict feasibility of scarf osteotomy preoperatively. The midshaft osteotomies commonly performed are the scarf osteotomy or z osteotomy and the ludloff osteotomy. This technique is based upon the training and expertise of the surgeon advisory team, along with its knowledge. However, no data are available directly comparing the two procedures. Predicting treatment success after scarf osteotomy for. Short term evaluation of combined scarf and akin osteotomies for treatment of hallux valgus. Abstract purpose we have reported the radiological and clinical outcome of scarf osteotomy in the treatment of moderate to severe hallux valgus among adolescent children. Longterm followup of a randomized controlled trial comparing scarf to chevron osteotomy in hallux valgus correction ralph m. Hallux valgus correction utilising a modified short scarf osteotomy with a magnesium biodegradable or titanium compression screws a comparative study of clinical outcomes. It was popularized in europe and the term originates from an architectural and carpentry term defined as.
The drawback of this study was its retrospective nature. Both studies did not address lesser metatarsal adductus, yet showed satisfactory results with small numbers and short followup 6,9,12. Pdf short versus standard scarf osteotomy for hallux valgus. Scarf osteotomy is an established procedure for correction of hallux valgus deformity. Scarf osteotomy and forefoot surgery planning 41 2 18 2010 be fit into the distal fragment, aiming toward the plantar aspect of the fifth metatarsal head in order to lower the head of the first metatarsal with the lateral displacement. Department of orthopaedic surgery, faculty of medicine, benha university,benha. Background ideal surgical treatment for hallux valgus is still controversial.
The diaphyseal scarf osteotomy has gained significant popularity due to its ability to achieve a greater degree of correction and stability. The mau osteotomy began as a modification of the ludloff proce dure in the early 20th century. Foot and ankle technique guide metatarsal shortening osteotomy. Indications discuss indications and more general concerns. The longitudinal cut is shorter, however, and the plantar cut is made in the diaphyseal portion of the metatarsal rather than in the metaphyseal. Kort, md, phd1, axel deenik, md, phd3, bob jong, md4, and roel p. The short scarf 1st metatarsal osteotomy springerlink. Mann et al presented a study with 92 primary hallux valgus corrections with a proximal osteotomy. Scarf and akin osteotomy the operation the operation is usually performed under a local anaesthetic. Proximal rotational metatarsal osteotomy for hallux valgus. Modified rotational scarf osteotomy for hallux valgus.
Outcomes after scarf osteotomy with and without akin osteotomy a. The trotation scarf and akin osteotomies for hallux valgus. Scarf osteotomy so is a very useful technique to treat tb and in some cases it represents the firstrate surgical treatment for this deformity. For this retrospective study, radiological assessments were used to measure outcomes in 72 feet with hallux valgus treated from. Biodegradable implants reduce the likelihood of further surgery for hardware removal and reduce the. The metatarsal osteotomy must be placed with great accuracy. Outcome of the scarf osteotomy in adolescent hallux valgus. Authors described surgical technique of the scarf osteotomy for hallux valgus correction. We conclude however, that in the short term, onestage shortening scarf osteotomy of the first metatarsal is a good alternative for correcting severe hallux valgus deformities. Scarf of the first metatarsal for bunionectomy journal of. The main advantages of this osteotomy are its stability and versatility, making it an option to consider for treatment of almost all types of hallux valgus.
It explains the benefits, risks and alternatives, as well. When the dmaa must be corrected, a shorter osteotomy with a greater rotational effect is made and. Shortening scarf osteotomy for correction of severe hallux. Modified scarf osteotomy for treatment of hallux valgus. Scarf osteotomy is it the procedure of choice in hallux. The scarf osteotomy is a wellestablished surgical method for correcting a. Mau described the reverse osteotomy, from dorsally and. Scarf osteotomy is it the procedure of choice in hallux valgus. Information sheet scarf osteotomy what is a scarf osteotomy.
However, clear guidelines defining indication criteria are missing. Brachymetatarsia of the fourth metatarsal, lengthening. Research article open access hallux valgus correction. Diaphyseal osteotomy of the 1st ray for hallux valgus and forefoot reconstruction. Scarf osteotomy for correction of hallux valgus with two fixation screws. Scarf osteotomy of the 1st metatarsal is a metaphyseodiaphyseal osteotomy. The patient can usually resume normal activities in a short period of time. Sidhu 2, abhay tillu 3 the foot and ankle online journal 9 2.
The seri distal metatarsal osteotomy and scarf osteotomy. The shortterm results of scarf osteotomy combined with distal soft tissue. This is a report on rso for treating hv with increased dmaa. Modified rotational scarf osteotomy for hallux valgus vumedi.
Conclusion scarf osteotomy for moderate to severe degrees of hallux valgus had very good. The local anaesthetic is administered via injections around the area of the bunion and the ankle. Shortening scarf osteotomy is increasingly being used to correct. The aim of this paper is to describe this little known pathology, analyze all surgical techniques. On discharge, you will be able to put weight through your heel, using a special shoe. March 2010 a modified rotational scarf osteotomy with lateral soft tissue release and akin osteotomy. Pdf hallux valgus correction utilising a modified short. A wide capsular release was performed and the metatarsal was elevated up and a lengthening scarf osteotomy performed. From january 1997 to june 1997 the scarf osteotomy was selected in 20 consecutive patients 12 female and eight male.
The following technique guide describes a metatarsal shortening technique using the hattrick osteotomy guide. Scarf osteotomy is a powerful and versatile procedure to correct hallux valgus deformity. Threeyear followup results of combined short scarf. Biomechanical studies suggest that the scarf procedure provides more. The excellent results reported by others could not, however, be reproduced by the author and the results are presented. Introduction the revolving scarf osteotomy for treating.
Foot and ankle technique guide metatarsal shortening. Since the description of scarf osteotomy by burutaran 15 in 1976, this procedure has been widely used for correction of hallux valgus deformities 16, 17, 18. Scarf osteotomy is an operation to correct a severe bunion hallux valgus deformity. The ludloff osteotomy was not fixated, and the mau osteotomy challenged its inherent instability to ground reactive forces, which would cause displacement of the dorsal fragment fig. Hallux valgus is one of the most common foot deformities. Hallux valgus correction utilising a modified short scarf. What is already known scarf osteotomy is a versatile procedure for hallux valgus correction. The short to mediumterm followup period could not have picked up all the cases of. The short cannulated drill bit offers a countersinking option to ensure the head of the screw will be completely.
Short versus standard scarf osteotomy for hallux valgus. The placement of the guide should be considered before placing the first k. Include any exams preformed under anesthesia positioning describe and provide or photos to illustrate p. An osteotomy is an operation when the bone, in this case, the metatarsal bone is divided and moved into the correct position. Scarf osteotomy, chevron osteotomy, akin osteotomy. The second cut starts just distal to this cut and is aimed to meet the first cut on the. The scarf accucut osteotomy guide system includes two guides short and long. The scarf osteotomy for the correction of hallux valgus.
The foot and ankle online journal the scarf osteotomy. A traditional distal metatarsal osteotomy with rigid fixation scarf procedure and a more minimally invasive approach to a distal metatarsal osteotomy, termed seri simple, effective, rapid, inexpensive, have proven successful with shortterm followup. Hallux valgus is the most common foot deformity seen within specialty foot and ankle clinics. However, scarf osteotomy is not suitable for severe hv deformities with a larger dmaa, and so we have created a surgical procedure defined as revolving scarf osteotomy rso to address this treatment deficit. Outcomes after scarf osteotomy with and without akin. This small study has demonstrated that corrective surgery using a modified short scarf osteotomy is clinically effective for isolated minimal and moderate isolated bunion deformities with patients improving significantly in the moxfq, faoi, and eq5d3 l scoring modalities. Scarf osteotomy in severe hallux valgus deformity waly ah, morsy. Each guide can produce cuts of varying lengths, with each cutting slot corresponding to a kwire hole. A scarf osteotomy is a type of procedure for hallux valgus and the term scarf describes the shape of the bone cut osteotomy that the surgeon uses. The scarf osteotomy for the correction of hallux valgus deformities.
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