Shortening Scarf osteotomy for correction of severe hallux valgus. Does shortening affect the outcome?

Background: Translation and shortening of Scarf osteotomy allows correction of severe hallux valgus deformity. Shortening may result in transfer metatarsalgia.

Aim: To evaluate outcome of patients undergoing shortening Scarf osteotomy for severe hallux valgus deformities.

Materials And Methods: Fifteen patients (20feet, mean age 58 years) underwent shortening Scarf osteotomy for severe hallux valgus deformities. Outcomes were pre and postoperative AOFAS scores, IM and HV angles, patient satisfaction.

Results: Mean follow-up was 25 months (range 22-30). The IM angle improved from a median of 18.60 (range 13.4-26.20) preoperatively to 9.70 (range 8.0-13.70) postoperatively (8.9; 95% CI=7.6-10.3; p<0.001). The HV angle improved from a mean of 43.2 (range 27.4-68.2) preoperatively to 13.6 (range 3.0-37.4) postoperatively (29.6; 95% CI=26.1-33.2; p<0.001). The median AOFAS score improved from 29.2 (range 14-60) preoperatively to 82.2 (range 55-100) postoperatively (53.0; 95% CI=48.0-58.5; p<0.001). All patients rated their satisfaction as either satisfied or very satisfied. None had symptoms of transfer metatarsalgia at final follow-up. All osteotomies united.

Conclusions: Shortening Scarf osteotomy is a viable option for treating severe hallux valgus deformities with no transfer metatarsalgia.