Hallux valgus treated by first metatarsal Scarf osteotomy. A series of 50 cases with a minimum follow up of two years

Purpose of the study Fifty hallux-valgus were treated with Scarf Osteotomy of the first metatarsal, associated to a phalangeal varisation or shortenin g osteotomy and an adductor plasty. Patients were evaluated with a minimum follow-up of two years. Material and methods Forty five females and two males were operated with an average age of fifty years. The pre operative metatarsus varus was of 15 d egrees 8. Mean alignment of metatarsal bar was 31 degrees 4. The cuneo-meta tarsal joint was twenty two times spheric and twenty eight times plane. The average metatarso-phalangeal great toe valgus was 39 degrees 8. Results They were appreciated with a minimal follow-up of two years, accord ing to the 3 Groulier's criteria: correction of deformation, statics troubl es, functional activity. The metatarsus varus improved with an average of 1 0 degrees 4, as well as the alignment of the metatarsal bar (25 degrees). T he post operative average phalangeal valgus was 22 degrees 7. These results were statistically significant. Cuneo-metatarsal joint type did not influe nced final result. Articulat joint line was normal in 64% of cases. Global result was excellent or good in 70%, passable in 22%, and bad in 8% of case s. Discussion Scarf Osteotomy of the first metatarsal allows complete correcti on of metatarsus varus. The surgical approach can be proposed at every age. There are no vascular trouble or arthrosis worsening. It must be completed with a phalangeal varisation or shortening osteotomy and adductor plasty.