Médecine et chirurgie du pied


Scarf Osteotomy without Osteosynthesis in Hallux Valgus Treatment Volume 31, issue 3, Juillet 2015


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Hallux valgus is the most frequent deformity of the forefoot pathology, especially among the female population.

This deformation involves a medial deviation of the first metatarsal head and a lateral deflection, with often, a pronation to hallux.

Hallux valgus is for more than a century and a half, a forefoot osteoarticular deformity, which has most fired the imagination of surgeons who were interested in this disease and its treatment.

Many surgical techniques and variants have been described over the years reaching about 150 therapeutic procedures.

Scarf osteotomy technique was first described by Burutaran in 1976, developped by Weil and Borelli in 1990 and popularized in France by Barouk.

We use for the treatment of hallux valgus an osteotomy Scarf without using internal fixation (osteosynthesis). This technique has been described by Maestro in 1999.

In our retrospective series of 35 feet operated in our department, we investigated the clinical and radiological results in order to evaluate our results and demonstrate the reliability and reproducibility of the technique we use. Technical changes to the classic Scarf made by Maestro consist in the realization of a proximal transverse and oblique osteotomy, the realization of a cutout in the medial side of the metatarsal head where is embedded the distal side corner of the proximal fragment, the replacement of the distal bone screw by an osteosuture and the replacement of the proximal screw by the isolation of the bone area, resected to the detriment of the proximal fragment after lateral shifting at the proximal portion of the osteotomy.

Scarf osteotomy without osteosynthesis, fulfills all the requirements for being a technique of choice in the treatment of hallux valgus providing excellent results for a low complication rate.