Marudanayagam Ashok, Appan Sadai V
University Hospital of Wales, Heath Park, Cardiff, United Kingdom.
Withybush General Hospital, Fishguard Road, Haverfordwest, United Kingdom.
J Orthop Surg (Hong Kong). 2014 Apr;22(1):39-41. doi: 10.1177/230949901402200111.
To report outcome of Scarf osteotomy with or without proximal phalangeal osteotomy for correction of severe hallux valgus deformity.
Records of 48 women and 4 men aged 28 to 68 (mean, 52) years who underwent 57 Scarf osteotomies with or without proximal phalangeal osteotomy for severe hallux valgus by a single surgeon were reviewed. The patients had a hallux valgus angle (HVA) of up to 55º. An additional proximal phalangeal osteotomy was performed in 11 of the patients whose hallux valgus persisted (HVA >10º). The American Orthopaedic Foot and Ankle Society (AOFAS) hallux score, the HVA and intermetatarsal angle (IMA) on radiographs, and the complication rate were assessed.
The mean follow-up period was 26 (range, 24-36) months. The mean AOFAS hallux score improved from 57.4 (range, 49-64) to 91.6 (range, 75-100). The mean HVA improved from 38.1º (range, 28º-52º) to 12.8º (range, 5º-20º). The mean IMA improved from 17.0º (range, 13º-24º) to 6.8º (range, 3º-10º). One patient developed chronic regional pain syndrome. There were no instances of non-union, delayed union, or malunion of the osteotomy site.
Scarf osteotomy with or without proximal phalangeal osteotomy is an effective treatment for correcting severe hallux valgus deformity.
报告采用或不采用近节趾骨截骨术的Scarf截骨术矫正重度拇外翻畸形的疗效。
回顾了由一名外科医生为48名女性和4名男性患者（年龄28至68岁，平均52岁）实施的57例采用或不采用近节趾骨截骨术的Scarf截骨术治疗重度拇外翻的记录。患者的拇外翻角（HVA）高达55°。11例拇外翻持续存在（HVA>10°）的患者还进行了近节趾骨截骨术。评估了美国矫形足踝协会（AOFAS）拇趾评分、X线片上的HVA和跖间角（IMA）以及并发症发生率。
平均随访期为26（范围24 - 36）个月。AOFAS拇趾平均评分从57.4（范围49 - 64）提高到91.6（范围75 - 100）。平均HVA从38.1°（范围28° - 52°）改善至12.8°（范围5° - 20°）。平均IMA从17.0°（范围13° - 24°）改善至6.8°（范围3° - 10°）。1例患者出现慢性区域疼痛综合征。截骨部位未发生骨不连、延迟愈合或畸形愈合情况。
采用或不采用近节趾骨截骨术的Scarf截骨术是矫正重度拇外翻畸形的有效治疗方法。
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