Minifragment screw fixation of the Scarf osteotomy.

BACKGROUND: Various techniques have been used for internal fixation of Scarf osteotomies. Stability of fixation plays an important role in determining the outcome. We prospectively studied 23 consecutive cases of hallux valgus treated with a scarf osteotomy, which were internally fixed with AO mini fragment screws. The aim of our study was to evaluate the clinical efficacy of the AO mini fragment screw used as fixation device in Scarf osteotomy.

MATERIALS AND METHODS: Twenty-three feet (1 male, 16 female) were evaluated. Bilateral procedures were performed on six patients. Mean age was 46 years. The mean followup was 18 months. One surgeon performed all the procedures.

RESULTS: 43.5% of the patients were very satisfied, 52.2% were satisfied and 4.34% were not satisfied. All osteotomies united without any hardware complications. The mean global AOFAS score improved significantly from a preoperative score of 55 points to 91.95 (p < 0.001). The intermetatarsal, hallux valgus angle, and DMMA improved from the mean preoperative values of 15.9 degrees, 31.2 degrees, and 14.1 degrees to 9.1 degrees, 15.2 degrees, and 8.4 degrees, respectively (p < 0.001 for all). One patient developed a superficial wound infection, which responded to antibiotics and one patient developed a painful spur at first MTPJ.

CONCLUSION: We conclude that this is a safe and simple technique of fixing a Scarf osteotomy. It is cost effective, provides stable fixation and maintains correction until the osteotomy unites.