Gupta Sanjay, Fazal Mohammad Ali, Williams Lloyd
16 Rosedale Mansions Boulevard, Hull HU3 2TE, United Kingdom.
Foot Ankle Int. 2008 Apr;29(4):385-9. doi: 10.3113/FAI.2008.0385.
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.
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.
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.
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.
多种技术已被用于Scarf截骨术的内固定。固定的稳定性在决定手术结果中起着重要作用。我们前瞻性地研究了连续23例采用Scarf截骨术治疗的拇外翻病例，并用AO微型碎片螺钉进行内固定。我们研究的目的是评估AO微型碎片螺钉作为Scarf截骨术固定装置的临床疗效。
对23只足（1例男性，16例女性）进行评估。6例患者接受了双侧手术。平均年龄为46岁。平均随访时间为18个月。所有手术均由一名外科医生完成。
43.5%的患者非常满意，52.2%的患者满意，4.34%的患者不满意。所有截骨均愈合，未出现任何内固定并发症。AOFAS总体平均评分从术前的55分显著提高至91.95分（p < 0.001）。第1、2跖骨间角、拇外翻角和第1跖趾关节远端关节面角分别从术前的平均15.9°、31.2°和14.1°改善至9.1°、15.2°和8.4°（所有p值均 < 0.001）。1例患者出现浅表伤口感染，经抗生素治疗后好转，1例患者在第1跖趾关节处出现疼痛性骨赘。
我们得出结论，这是一种安全、简单的Scarf截骨术固定技术。它具有成本效益，能提供稳定的固定，并在截骨愈合前维持矫正效果。
