Possibilities of Scarf osteotomy in surgical correction of hallux valgus
https://doi.org/10.34215/1609-1175-2024-4-21-26
Abstract
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.
Supporting agencies: The authors declare funding for the study from their own funds.
About the Authors
R. V. Pryanishnikov
Clinic of foot pathology "Podiatry Lab"; Far Eastern State Medical University
Russian Federation
Russian Federation
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
V. E. Volovik
Far Eastern State Medical University
Russian Federation
Russian Federation
Khabarovsk
E. P. Kostiv
Pacific State Medical University
Russian Federation
Russian Federation
Vladivostok
E. E. Kostiva
Pacific State Medical University
Russian Federation
Russian Federation
Vladivostok
References
1. Amlashi FI, Norouzi Z, Sohrabi A, Shirzad-Aski H, Norouzi A, Ashkbari A, Gilani N, Fatemi SA, Besharat S. A systematic review and meta-analysis for association of Helicobacter pylori colonization and celiac disease. PLoS One. 2021; 16(3):e0241156. doi: 10.1371/journal.pone.0241156
2. Munir U, Mabrouk A, Dreyer MA, Morgan S. Hallux Varus. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2024.
3. Blackwood S, Gossett L. Hallux valgus/medial column instability and their relationship with posterior tibial tendon dysfunction. Foot Ankle Clin. 2018;23(2):297–313. doi: 10.1016/j.fcl.2018.02.003
4. Ray JJ, Friedmann AJ, Hanselman AE, Vaida J, Dayton PD, Hatch DJ, Smith B, Santrock RD. Hallux Valgus. Foot Ankle Orthop. 2019;4(2):2473011419838500. doi: 10.1177/2473011419838500
5. Fraissler L, Konrads C, Hoberg M, Rudert M, Walcher M. Treatment of hallux valgus deformity. EFORT Open Rev. 2016;1(8):295–302. doi: 10.1302/2058-5241.1.000005
6. Ferreira GF, Nunes GA, Banca V, Michaelis LF, Lewis TL, Ray R, Lam P, Pereira Filho MV. Minimally invasive hallux valgus surgery using 3D printed patient specific instrumentation. Arch. Orthop. Trauma Surg. 2024;144(6):2553-9. doi: 10.1007/s00402-024-05383-6
7. Faroug R, Bagshaw O, Conway L, Ballester JS. Increased recurrence in Scarf osteotomy for mild & moderate hallux valgus with Meary's line disruption. Foot Ankle Surg. 2019;25(5):608–11. doi: 10.1016/j.fas.2018.06.002
8. Flaherty A, Chen J. Minimally invasive chevron Akin osteotomy for hallux valgus correction. JBJS Essent. Surg. Tech. 2024;14(1):e22.00021. doi: 10.2106/JBJS.ST.22.00021
9. Torrent J, Baduell A, Vega J, Malagelada F, Luna R, Rabat E. Open vs minimally invasive Scarf osteotomy for hallux valgus correction: A randomized controlled trial. Foot Ankle Int. 2021;42(8):982–93. doi: 10.1177/10711007211003565
10. Rouveyrol M, Harrosch S, Curvale G, Rochwerger A, Mattei JC. Does screwless scarf osteotomy for hallux valgus increase the risk of transfer metatarsalgia? Orthop. Traumato. l Surg. Res. 2021;107(6):102853. doi: 10.1016/j.otsr.2021.102853
11. Tao T, Jiang Y, Li W, Li Y, Du J, Gui J. Relationship of vitamin D receptor gene polymorphisms with susceptibility, surgical outcome and prognosis of hallux valgus in a Chinese Han population. Foot Ankle Surg. 2019;25(2):198–203. doi: 10.1016/j.fas.2017.10.010
12. Kido M, Ikoma K, Sotozono Y, Ikeda R, Imai K, Maki M, Ohashi S, Kubo T. The influence of hallux valgus and flatfoot deformity on metatarsus primus elevatus: A radiographic study. J. Orthop. Sci. 2020;25(2):291–6. doi: 10.1016/j.jos.2019.03.020
13. Kanemitsu M, Nakasa T, Ikuta Y, Sumii J, Nekomoto A, Kawabata S, Deie M, Adachi N. Morphology and deformity of the distal phalanx in hallux valgus. J. Orthop. Sci. 2023:S0949-2658(23)00269–5. doi: 10.1016/j.jos.2023.09.010
14. Nebhani N, Yatin Trivedy M, Heyes G, Molloy A, Mason L. Hallux valgus interphalangeus measurement: comparison of the 2 radiographic methods. Foot Ankle Spec. 2022:19386400221078677. doi: 10.1177/19386400221078677
15. Ahn J, Jeong BO. Relationship between foot width reduction and clinical outcomes after Chevron osteotomy for hallux valgus deformity. Clin. Orthop. Surg. 2023;15(1):159–65. doi: 10.4055/cios21272
16. Milczarek M, Nowak K, Tomasik B, Milczarek J, Laganowski P, Domzalski M. Additional Akin proximal phalanx procedure has a limited effect on the outcome of Scarf osteotomy for hallux valgus surgery. J. Am. Podiatr. Med. Assoc. 2021;111(6). doi: 10.7547/20-071
17. Butler JJ, Hartman H, Rettig S, Konar K, Randall G, Samsonov AP, Kennedy JG. Similar outcomes following scarf-Akin osteotomy compared to scarf-alone osteotomy for the treatment of hallux valgus : A systematic review and meta-analysis. Foot Ankle Surg. 2024;30(4):299–308. doi: 10.1016/j.fas.2024.01.003
18. Zhang FQ, Zhang Y, Wang X, Wang XM, Li YS, Luo ZX. Scarf osteotomy combined with soft tissue balance release for severe hallux valgus. Zhongguo Gu Shang. 2022;35(12):1132–7. doi: 10.12200/j.issn.1003-0034.2022.12.005
19. Kramer J, Barry LD, Helfman D, Mehnert JA, Pokrifcak VM. The modified Scarf bunionectomy. J. Foot Surg. 1992;31(4):360–7.
20. Barouk LS. Scarf osteotomy for hallux valgus correction. Local anatomy, surgical technique, and combination with other forefoot procedures. Foot Ankle Clin. 2000;5(3):525–58.
21. Barouk LS. The effect of gastrocnemius tightness on the pathogenesis of juvenile hallux valgus: a preliminary study. Foot Ankle Clin. 2014; 19(4):807–22. doi: 10.1016/j.fcl.2014.08.005
22. Tan MWP, Chen JY, Yeo EMN. Clinical outcomes of Scarf-Akin osteotomy for hallux valgus with simultaneous Bunionette correction: A propensity score-matched cohort analysis. J. Foot Ankle Surg. 2022;61(3):520–7. doi: 10.1053/j.jfas.2021.10.003
23. Cano DP, Lagos MA, Baduell A, González JTA, Torre CM, Rios J. Immediate effect of hallux valgus surgery on the biomechanical behavior of the first ray. Foot Ankle Surg. 2024:S1268–7731(24)00074–2. doi: 10.1016/j.fas.2024.04.001
24. Ferreira GF, Borges VQ, Moraes LVM, Stéfani KC. Percutaneous Chevron/Akin (PECA) versus open scarf/Akin (SA) osteotomy treatment for hallux valgus : A systematic review and meta-analysis. PLoS One. 2021; 16(2):e0242496. doi: 10.1371/journal.pone.0242496
25. Castioni D, Fanelli D, Gasparini G, Iannò B, Galasso O. Scarf osteotomy for the treatment of moderate to severe hallux valgus: Analysis of predictors for midterm outcomes and recurrence. Foot Ankle Surg. 2020;26(4):439–44. doi: 10.1016/j.fas.2019.05.013
26. Xiang L, Mei Q, Wang A, Fernandez J, Gu Y. Gait biomechanics evaluation of the treatment effects for hallux valgus patients : A systematic review and meta-analysis. Gait Posture. 2022;94:67–78. doi: 10.1016/j.gaitpost.2022.02.026
27. Skrebtsov AV, Nikitina VK, Protsko VG, Tamoev SK, Skrebtsov VV, Yakushev DS. Analysis of medium-term results of correction of hallux valgus deformity of the first toe. N.N. Priorov Journal of Traumatology and Orthopedics. 2023;30 (3):315–24 (In Russ.)
28. Clee S, Flanagan G, Pavier J, Reilly I. Correction of hallux abducto valgus by scarf osteotomy. A ten-year retrospective multicentre review of patient reported outcomes shows high satisfaction rates with podiatric surgery. J. Foot Ankle Res. 2022;15(1):44. doi: 10.1186/s13047-022-00546-3
29. Wu JD, Chen ZU, Qi YZ, Li XY, Pan XU, Hong MA, Jin BR, Ma ZU. Effect of Scarf and Chevron combined with Akin on postoperative balance in patients with moderate to severe foot bunion. Eur. Rev. Med. Pharmacol. Sci. 2023;27(17):8225–33. doi: 10.26355/eurrev_202309_33583
30. Kuliński P, Tomczyk Ł, Pawik Ł, Olech J, Morasiewicz P. Radiographic outcomes of hallux valgus deformity correction with Chevron and Scarf osteotomies. J. Foot Ankle Surg. 2023;62(4):676–82. doi: 10.1053/j.jfas.2023.02.007
31. Wang X, Wen Q, Li Y, Liu C, Zhao K, Zhao H, Liang X. Introduction the revolving scarf osteotomy for treating severe hallux valgus with an increased distal metatarsal articular angle: a retrospective cohort study. BMC Musculoskelet. Disord. 2019;20(1):508. doi: 10.1186/s12891-019-2874-8
32. Lorei TJ, Kinast C, Klärner H, Rosenbaum D. Pedographic, clinical, and functional outcome after scarf osteotomy. Clin. Orthop. Relat. Res. 2006; 451:161–6. doi: 10.1097/01.blo.0000229297.29345.09
33. Tay AYW, Goh GS, Koo K, Yeo NEM. Third-generation minimally Invasive Chevron-Akin Osteotomy for Hallux Valgus Produces Similar clinical and radiological outcomes as Scarf-Akin osteotomy at 2 years: A matched cohort study. Foot Ankle Int. 2022;43(3):321–30. doi: 10.1177/10711007211049193
34. Alshehri AS, Alzahrani FA, Aljaafri ZA, Shalash NA. Outcomes of hallux valgus corrective osteotomy: A tertiary hospital experience. Cureus. 2023;15(10):e46422. doi: 10.7759/cureus.46422
35. Sieloff MR, Tokarski AR, Elliott AD, Jacobs PM, Borgert AJ. The Incidence of complications following Scarf osteotomy for the treatment of hallux valgus : A systematic review with meta-analysis. J. Foot Ankle Surg. 2023;62(4):610–7. doi: 10.1053/j.jfas.2022.11.017
36. Choi JH, Zide JR, Coleman SC, Brodsky JW. Prospective study of the treatment of adult primary hallux valgus with scarf osteotomy and soft tissue realignment. Foot Ankle Int. 2013;34(5):684–90. doi: 10.1177/1071100712472489
37. Hagio T, Yoshimura I, Kanazawa K, Minokawa S, Ishimatsu T, Nagatomo M, Sugino Y, Yamamoto T. Risk factors for recurrence of hallux valgus deformity after minimally invasive distal linear metatarsal osteotomy. J. Orthop. Sci. 2022;27(2):435-9. doi: 10.1016/j.jos.2020.12.013
38. Lipscombe S, Molloy A, Sirikonda S, Hennessy MS. Scarf osteotomy for the correction of hallux valgus: midterm clinical outcome. J. Foot Ankle Surg. 2008;47(4):273–7. doi: 10.1053/j.jfas.2008.02.021
39. Suh JW, Jang HS, Park HW. Iatrogenic second transfer metatarsalgia and the first metatarsal shortening and elevation after Scarf osteotomy. Foot Ankle Surg. 2022;28(4):464–70. doi: 10.1016/j.fas.2021.11.005
40. Lalevee M, de Cesar Netto C, ReSurg, Boublil D, Coillard JY. Recurrence rates with longer-term follow-up after hallux valgus surgical treatment with distal metatarsal osteotomies : A systematic review and meta-analysis. Foot Ankle Int. 2023;44(3):210–22. doi: 10.1177/10711007231152487
41. Ezzatvar Y, López-Bueno L, Fuentes-Aparicio L, Dueñas L. Prevalence and predisposing factors for recurrence after hallux valgus surgery: A systematic review and meta-analysis. J. Clin. Med. 2021; 10(24):5753. doi: 10.3390/jcm10245753
42. Shibuya N, Kyprios EM, Panchani PN, Martin LR, Thorud JC, Jupiter DC. Factors associated with early loss of hallux valgus correction. J. Foot Ankle Surg. 2018;57(2):236–40. doi: 10.1053/j. jfas.2017.08.018
43. Li X, Guo M, Zhu Y, Xu X. The excessive length of first ray as a risk factor for hallux valgus recurrence. PLoS One. 2018;13(10):e0205560. doi: 10.1371/journal.pone.0205560
44. Heyes GJ, Vosoughi AR, Weigelt L, Mason L, Molloy A. Pes planus deformity and its association with hallux valgus recurrence following Scarf osteotomy. Foot Ankle Int. 2020;41(10):1212–8. doi: 10.1177/1071100720937645
45. Silva BAMD, Zandoná DA, Siqueira DB, Alves RA. Scarf osteotomy for hallux valgus correction: radiological and clinical analysis. Acta Ortop. Bras. 2022;30(4):e249410. doi: 10.1590/1413-785220223004e249410
46. Park CH, Lee WC. Recurrence of hallux valgus can be predicted from immediate postoperative non-weight-bearing radiographs. J. Bone Joint Surg. Am. 2017;99(14):1190–7. doi: 10.2106/JBJS.16.00980
47. Li Z, Yu W, Lin A, Fu K, Fang Z. Comparative effects of modified rotary scarf osteotomy and traditional Scarf osteotomy in treating moderate to severe hallux valgus: a retrospective cohort study. BMC Musculoskelet. Disord. 2024;25(1):61. doi: 10.1186/s12891-023-07156-5
Review
For citations:
Pryanishnikov R.V., Volovik V.E., Kostiv E.P., Kostiva E.E. Possibilities of Scarf osteotomy in surgical correction of hallux valgus. Pacific Medical Journal. 2024;(4):21-26. (In Russ.) https://doi.org/10.34215/1609-1175-2024-4-21-26
Views:
305
Email this article 