Scarf and Akin osteotomies for moderate and severe hallux valgus: clinical and radiographic results.

BACKGROUND: The scarf and the combined scarf-Akin procedures are reliable therapeutic tools and can obtain effective correction of symptomatic moderate to severe hallux valgus deformities.

METHODS: The data from 30 patients (37 feet) with moderate to severe hallux valgus deformity who had scarf osteotomies have been retrospectively reviewed. 32 Akin and 77 Weil osteotomies were also carried out at the same stage. The average follow-up was 22 months. Standardized methods of radiographic and clinical data collection were obtained before and after surgery. Patient satisfaction was assessed at follow-up.

RESULTS: Radiological assessment revealed a significant improvement (p<0.001) of the hallux valgus angle (mean reduction 17.4 degrees), the intermetatarsal angle (mean reduction 5.8 degrees), the medial sesamoid position (14% of the feet were grade 1 or less preoperatively and this rate increased to 84% at follow-up) and the DMAA (mean reduction 9 degrees). The complication rate was 19%. Clinical improvement was achieved with the AOFAS score increasing from 46 to 86 points (p<0.001).

CONCLUSIONS: We conclude that the procedure has value in obtaining predictable correction of moderate to severe hallux valgus deformities.