Podiatric Medicine and Surgery Resident, Gundersen Health Systems, La Crosse, WI.
Podiatric Medicine and Surgery Resident, Gundersen Health Systems, La Crosse, WI.
J Foot Ankle Surg. 2023 Jul-Aug;62(4):610-617. doi: 10.1053/j.jfas.2022.11.017. Epub 2022 Nov 28.
The Scarf osteotomy is a surgical procedure performed to correct a hallux valgus deformity. Multiple studies have supported use of the procedure with favorable outcomes. In contrast, there have been studies showing a significant complication rate with the procedure. Incidence of complications remains underreported in the literature. We performed a systemic review and meta-analysis examining a wide range of reported complications and associated clinical outcomes from the Scarf osteotomy. One hundred and sixteen publications were identified and 25 (21.6%) met our inclusion criteria. A total of 1583 Scarf procedures were included. Weighted mean follow-up was 26.4 months [range 12-168 months]. We found a 5.1% rate of recurrence, 3.5% rate of troughing, 1.0% rate of avascular necrosis, 1.8% rate of nonunion, 2.7% rate of malunion, 2.4% rate of infection, 5.3% rate of complex regional pain syndrome, and 3.4% rate of hallux varus. An average decrease in intermetatarsal angle of 6.3° was observed. No statistical difference was found in outcomes when comparing Scarf versus Scarf with additional procedure performed at time of surgery. To our knowledge, this systematic review and meta-analysis contains the highest number of Scarf procedures analyzed and presents complication rates on multiple adverse outcomes.
Scarf 截骨术是一种用于矫正拇外翻畸形的手术。多项研究支持该手术的应用，并取得了良好的效果。然而，也有研究表明该手术存在较高的并发症发生率。该手术的并发症发生率在文献中报道较少。我们进行了一项系统评价和荟萃分析，研究了 Scarf 截骨术的多种报告并发症及其相关临床结局。共确定了 116 篇出版物，其中 25 篇（21.6%）符合我们的纳入标准。共纳入了 1583 例 Scarf 手术。加权平均随访时间为 26.4 个月[范围 12-168 个月]。我们发现复发率为 5.1%，切迹率为 3.5%，缺血性坏死率为 1.0%，骨不连率为 1.8%，愈合不良率为 2.7%，感染率为 2.4%，复杂性区域疼痛综合征率为 5.3%，拇外翻率为 3.4%。观察到跖骨间角平均减少 6.3°。在比较 Scarf 与 Scarf 加手术时附加手术的结果时，未发现统计学差异。据我们所知，这项系统评价和荟萃分析包含了分析的最多数量的 Scarf 手术，并提出了多种不良结局的并发症发生率。
