J Korean Foot Ankle Soc.  2019 Dec;23(4):154-158. 10.14193/jkfas.2019.23.4.154.

Clinical Results Over Time for Unilateral versus Bilateral Simultaneous Short Scarf Osteotomy

• Jeong C
• Park IK
• Chung JW

• KMID: 2465938
• DOI: http://doi.org/10.14193/jkfas.2019.23.4.154

Abstract

PURPOSE
This study compared the radiographic and clinical outcomes of simultaneous bilateral short scarf osteotomy with those of unilateral short scarf osteotomy in hallux valgus patients.
MATERIALS AND METHODS
The authors undertook a retrospective chart and radiographic review between January 2015 and June 2017 to identify 15 patients (30 cases, group A) who underwent a simultaneous bilateral short scarf osteotomy. The patients were matched with 30 patients (30 cases, group B) with a unilateral short scarf osteotomy. No significant preoperative differences were observed between the two groups in terms of age, gender, American Orthopaedic Foot and Ankle Society (AOFAS) hallux score, and radiographic parameters. The clinical and radiographic follow-up was carried out at three months and one year.
RESULTS
Hallux valgus angles in groups A and B were reduced from the mean preoperative values of 32.5° and 34.7° to 12.5° and 12.2° at 12 months, respectively. The first-second intermetatarsal angles in groups A and B were also reduced from the mean preoperative values of 14.2° and 16.5° to 7.4° and 7.3° at 12 months, respectively. No significant inter-group differences in radiographic outcomes were observed. After three months, the patients in group A reported significantly worse mean pain and functional scores than group B. The mean AOFAS hallux score was higher in group B at the three-month follow-up, but this difference disappeared at the one-year follow-up.
CONCLUSION
Simultaneous bilateral surgery can be offered to patients with a hallux valgus deformity requiring correction. On the other hand, they should be informed of the long recovery period.

Keyword

Bilateral surgery; Hallux valgus; Short scarf osteotomy

MeSH Terms

Ankle
Congenital Abnormalities
Follow-Up Studies
Foot
Hallux
Hallux Valgus
Hand
Humans
Osteotomy*
Retrospective Studies

Figure

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  Figure 1 Photographs of short scarf osteotomy shows the longitudinal skin incision was extended approximately 25 mm from the base of the proximal phalanx to the metatarsal shaft and the scarf osteotomy that has short longitudinal cut was marked in line (A), and the distal fragment was translated laterally from 7 mm to 11 mm after completion of the osteotomy (B).

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  Figure 2 Preoperative (A), postoperative 4-month (B) and postoperative 12-month (C) follow-up weight bearing anteroposterior foot radiographs of 57-year-old female who underwent bilateral synchronous scarf surgery showed decrease of the hallux valgus and the first-second intermetatarsal angles after the surgery.

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