pmjТихоокеанский медицинский журналPacific Medical Journal1609-1175TGMU10.34215/1609-1175-2024-4-21-26pmj-2823Research ArticleОБЗОРЫREVIEWSВозможности применения Scarf-остеотомии в хирургической коррекции вальгусной деформации первого пальца стопыPossibilities of Scarf osteotomy in surgical correction of hallux valgushttps://orcid.org/0009-0004-7824-3712ПрянишниковР. В.PryanishnikovR. V.

Роман Вячеславович Прянишников, врач–травматолог-ортопед, главный врач, аспирант

кафедра травматологии и ортопедии

680031; ул. Карла Маркса, 144/2в, кв. 96; Хабаровск

тел. 8 (914) 548-71-84

Roman V. Pryanishnikov, orthopedic traumatologist, Chief Physician, postgraduate student

Department of Traumatology and Orthopedics

680031; 144/2b, ap. 96 Karl Marx str.; Khabarovsk

phone: 8 (914) 548-71-84

podiatrylab.dir@yandex.ruВоловикВ. Е.VolovikV. E.

Хабаровск

Khabarovsk

КостивЕ. П.KostivE. P.

Владивосток

Vladivostok

КостиваЕ. Е.KostivaE. E.

Владивосток

Vladivostok

Клиника патологии стопы «Podiatry Lab»; Дальневосточный государственный медицинский университетРоссияClinic of foot pathology "Podiatry Lab"; Far Eastern State Medical UniversityRussian FederationДальневосточный государственный медицинский университетРоссияFar Eastern State Medical UniversityRussian FederationТихоокеанский государственный медицинский университетРоссияPacific State Medical UniversityRussian Federation202416022025042126Copyright © Прянишников Р.В., Воловик В.Е., Костив Е.П., Костива Е.Е., 20252025Прянишников Р.В., Воловик В.Е., Костив Е.П., Костива Е.Е.Pryanishnikov R.V., Volovik V.E., Kostiv E.P., Kostiva E.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tmj-vgmu.ru/jour/article/view/2823

   Вальгусная деформация первого пальца стопы (hallux valgus) – комплексная прогрессирующая деформация стопы, вызываемая дисбалансом статических и динамических ограничений, приводящих к отклонению головки плюсневой кости в аксиальной, корональной и сагиттальной плоскостях. Эффективность хирургического лечения этой деформации колеблется от 80 до 95 %, в то же время 15–40 % больных отмечают неудовлетворенность результатами хирургического лечения деформаций стопы. В качестве оптимального метода коррекции деформации hallux valgus рассматривается Scarf-остеотомия, при которой выполняется Z-образный разрез в области первой плюсневой кости с уменьшением величины межплюсневого угла. Преимущества Scarf-остеотомии заключаются в обеспечении стабильности и жесткой компрессии в области остеотомии, что дает возможность быстрой нагрузки на ногу и билатерализации. Scarf-остеотомия позволяет предотвратить укорочение первого луча стопы и обеспечить раннюю мобилизацию пациента. Это вмешательство выполняется при различных степенях деформации стопы, от легких до тяжелых. Наиболее частыми осложнениями хирургического лечения hallux valgus являются сохранение болевого синдрома, рецидив деформации, варусная деформация первого пальца стопы, вторичное смещение костных фрагментов, аваскулярный некроз головки первой плюсневой кости, несращение костей, инфекция.

   Hallux valgus refers to a complex progressive deformity of the foot, caused by an imbalance of static and dynamic constraints leading to the deviation of the head of metatarsal bone in axial, coronal, and sagittal planes. The efficacy of surgical treatment for this deformity ranges from 80 % to 95 %, while 15 % to 40 % of patients report dissatisfaction with the outcomes of foot deformity surgeries. Scarf osteotomy is considered the optimal method for correcting hallux valgus deformity, involving a Z-shaped cut in the area of the first metatarsal bone, which reduces the intermetatarsal angle. The advantages of scarf osteotomy include providing stability and rigid compression at the osteotomy site, allowing for early weight-bearing and bilateralization. Scarf osteotomy prevents shortening of the first ray and facilitates early mobilization of the patient. It can be performed for varyious degrees of foot deformity, from mild to severe. The most common complications associated with surgical treatment of hallux valgus include persistent pain syndrome, recurrence of deformity, hallux varus, secondary fragment displacement, avascular necrosis of the first metatarsal head, nonunion, and infection.

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The authors declare that there are no conflicts of interest present.