OFZ Innsbruck, Orthopedic and Foot Centre Innsbruck, Innrain 2/3. Stock, 6020, Innsbruck, Austria.
Institute of Patient-centered Outcome Research (IIPCOR), Dr. Stumpf Straße 56, 6020, Innsbruck, Austria.
Foot Ankle Surg. 2020 Jun;26(4):425-431. doi: 10.1016/j.fas.2019.05.007. Epub 2019 May 27.
Scarf osteotomy is a frequently used technique to correct moderate to severe hallux valgus deformities. Recurrence of a deformity is a commonly reported complication after surgery. The aim of our study was to evaluate the impact of preoperative deformity on radiological outcome in terms of postoperative loss of correction after scarf osteotomy.
102 patients, in which a hallux valgus deformity was corrected with an isolated scarf osteotomy were included. Weightbearing radiographs were analyzed preoperatively, postoperatively, after 6 weeks and after three months (mean 10.9 months SD 17.2 months). The following radiological parameters were used for analysis: the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA), position of the sesamoids, first metatarsal length, and first metatarsophalangeal joint congruity.
Significant correction of IMA, HVA, DMAA, sesamoid position and joint congruity was achieved (p < 0.001). The IMA improved from 15.8 ± 2.3 to 4.3 ± 2.8°, the HVA from 32.6 ± 6.8 to 9.1 ± 7.2, and the DMAA from 11.4 ± 6.9 to 8.4 ± 5.2°, respectively. In contrast to DMAA, throughout followup we could detect loss of correction for HVA and for IMA amounting 6.3° ± 5.8 and 3.8° ± 2.8 respectively. Loss of HVA correction revealed a significant correlation with preoperative DMAA, but not with the other preoperative radiological parameters.
Preoperative deformity does not correlate with postoperative loss of correction after scarf osteotomy, except DMAA.
Our results may be helpful in counseling patients regarding recurrence of hallux valgus deformity after scarf osteotomy.
Therapeutic, Level IV, retrospective case series.
Scarf 截骨术是一种常用于矫正中度至重度拇外翻畸形的技术。手术后畸形复发是一种常见的并发症。我们的研究目的是评估术前畸形对放射学结果的影响，即 scarf 截骨术后矫正丢失的程度。
纳入 102 例接受单纯 Scarf 截骨术矫正拇外翻畸形的患者。对术前、术后、术后 6 周和术后 3 个月（平均 10.9 个月，标准差 17.2 个月）的负重位 X 线片进行分析。分析的影像学参数包括：跖骨间角（IMA）、拇外翻角（HVA）、远端跖骨关节角（DMAA）、籽骨位置、第一跖骨长度和第一跖趾关节吻合度。
IMA、HVA、DMAA、籽骨位置和关节吻合度均有显著改善（p < 0.001）。IMA 从 15.8±2.3 改善至 4.3±2.8°，HVA 从 32.6±6.8 改善至 9.1±7.2°，DMAA 从 11.4±6.9 改善至 8.4±5.2°。与 DMAA 不同的是，在整个随访过程中，我们发现 HVA 和 IMA 的矫正丢失量分别为 6.3°±5.8 和 3.8°±2.8。HVA 矫正丢失与术前 DMAA 显著相关，但与其他术前影像学参数无关。
除 DMAA 外，术前畸形与 scarf 截骨术后矫正丢失无相关性。
我们的研究结果可能有助于向接受 scarf 截骨术的患者提供有关拇外翻畸形复发的咨询。
治疗，IV 级，回顾性病例系列。
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