Scarf-Akin Osteotomy Correction for Hallux Valgus: Short-term Results from a District General Hospital

Abstract 

This study assessed the radiological measurements, American Orthopaedic Foot and Ankle Society (AOFAS) scores, and patient satisfaction associated with performance of the scarf osteotomy, combined with an Akin osteotomy, for the treatment of hallux valgus in patients at a general hospital. Thirty-five patients were assessed before surgery, and at 6 months following performance of the scarf first metatarsal osteotomy plus Akin osteotomy. The mean first intermetatarsal and hallux abductus angles reduced from 14.1° ± 3.5° to 10.0° ± 3.2° and 32.1° ± 9.9° to 16.4° ± 7.9°, respectively, and these differences were statistically significant (P < .001). The mean first to second metatarsal sagittal plane length ratio was unchanged by the osteotomy (P > .05). The mean global AOFAS Hallux Metatarsophalangeal-Interphalangeal score increased from 58.8 ± 11.6 to 86.4 ± 11.6, and this difference was statistically significant (P < .0001). Of the 35 patients (36 operated feet), 20 (57.1%) were extremely satisfied, 10 (28.6%) were satisfied, and 5 (14.3%) were unsatisfied with the results of the surgery. Based on these results, we concluded that the improved radiographic angles and AOFAS scores observed in this study were comparable to previously reported results, and our findings indicated that, in the setting of a general hospital, the scarf osteotomy combined with the Akin osteotomy is a safe, versatile and useful procedure for the treatment of hallux valgus.

Level of Clinical Evidence: 2

Keywords: hallux valgus angle, bunionectomy, metatarsal, outcome, radiograph