Galli M, Muratori F, Visci F, Pezzillo F, Aulisa A G
Clinica Ortopedica, Università Cattolica del Sacro Cuore, Roma, Italia.
Clin Ter. 2007 May-Jun;158(3):209-12.
The aim of our study was to analize the results at middle term after M1 "Scarf" osteotomy
We have assessed subjective, clinical and radiologic result of 25 patients operated on for symptomatic hallux valgus by means of diaphyseal SCARF osteotomy, 19 females and 6 men with middle age of 50 y. All the patients were evaluated at 3 months and 1 year from operation and results were compared on clinic and radiologic level and on the base of functional and subjective outcome of patients. Clinical state, at 24 month, was assessed by Hallux Metatarsophalangeal Interphalangeal Scale score system as developed by the American Orthopaedic Foot and Ankle Society (AOFAS Score).
It has been observed a remarcable improvement of AOFAS score that varied from 40 to 81 point. In particular, we recorded an improvement of pain from 15 to 29, function from 23 to 40 and alignment from 2 to 12 point. Radiologic angle are also improved: the first metatarsal angle was changed from 16 degrees to 10 degrees degree, the hallux valgus angle from 32 degrees to 17 degrees, the distal articular metatarsal angle from 13 degrees to 10 degrees. M1-M5 angle to 33 degrees to 28 degreees. Méary-Tomeno angle was no significantly changed after surgeon. On subjective level, at follow-up time, 19 patients have declared to be very satisfied, 4 satisfied and only one dissatisfied. Nobody had pain and 1 patient was dissatisfied of a haestetic result.
Based on results, "Scarf" osteotomy permits an adequate deformity correction of first metatarsus varus also with intermetatarsal angle between first and second metatarsal superior to 20 degrees degree.
本研究的目的是分析M1“斯卡夫”截骨术后中期的结果。
我们评估了25例因症状性拇外翻接受骨干斯卡夫截骨术的患者的主观、临床和放射学结果,其中19例女性和6例男性,平均年龄50岁。所有患者在术后3个月和1年进行评估,并在临床和放射学水平以及患者功能和主观结果的基础上进行结果比较。24个月时的临床状态通过美国矫形足踝协会(AOFAS评分)制定的拇趾跖趾间关节量表评分系统进行评估。
观察到AOFAS评分有显著改善,从40分提高到81分。特别是,我们记录到疼痛从15分改善到29分,功能从23分改善到40分,对线从2分改善到12分。放射学角度也有所改善:第一跖骨角从16度变为10度,拇外翻角从32度变为17度,远端关节跖骨角从13度变为10度。M1-M5角从33度变为28度。梅里-托梅诺角在手术后无显著变化。在主观层面,随访时,19例患者表示非常满意,4例满意,只有1例不满意。没有人有疼痛,1例患者对美学结果不满意。
基于结果,“斯卡夫”截骨术能够对第一跖骨内翻进行充分的畸形矫正,即使第一和第二跖骨之间的跖间角大于20度。