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Foot Ankle Surg. 2019 May 27. pii: S1268-7731(18)30338-2. doi: 10.1016/j.fas.2019.05.007. [Epub ahead of print]

Does preoperative deformity diminish radiographic outcome after hallux valgus correction with scarf osteotomy?: A retrospective study of 102 cases.

Author information

1
OFZ Innsbruck, Orthopedic and Foot Centre Innsbruck, Innrain 2/3. Stock, 6020, Innsbruck, Austria. Electronic address: gerhard.kaufmann9@chello.at.
2
Institute of Patient-centered Outcome Research (IIPCOR), Dr. Stumpf Straße 56, 6020, Innsbruck, Austria. Electronic address: johannes.giesinger@iipcor.org.
3
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.
4
Orthopedic Department, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. Electronic address: matthias.braito@gmail.com.
5
Orthopedic Department, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. Electronic address: rainer.biedermann@i-med.ac.at.
6
Orthopedic Department, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. Electronic address: dietmar.dammerer@tirol-kliniken.at.

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.

KEYWORDS:

Hallux valgus; Loss of correction; Preoperative deformity; Prognostic factors; Radiological outcome; Scarf osteotomy

PMID:
31202526
DOI:
10.1016/j.fas.2019.05.007

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