Scarf osteotomy for the correction of hallux valgus: midterm clinical outcome

We prospectively reviewed 22 patients (31 feet) who underwent a scarf osteotomy between January 2001 and March 2002. There were 20 females and 2 males. Ages ranged from 35 to 77 years (mean = 57 years). American Orthopedic Foot and Ankle Society (AOFAS) scores improved from a preoperative mean of 47.94 +/- 13.57 and increased significantly to 96.10 +/- 6.15 (P < .01) after 12 months. The hallux valgus angle improved in all patients from a preop mean of 31.4 +/- 8.0 degrees to 11.0 +/- 10.8 degrees at 12 months. The intermetatarsal angle improved from 13.0 +/- 4.2 degrees to 6.1 +/- 3.2 degrees. All of these changes were significant. Bony union was achieved in all patients. There were no significant changes in peak pressure, pressure/time, or force/time pedobarography noted after 12 months. Significant improvement in pain scores from preoperative mean of 21.29 +/- 11.0 to 32.90 +/- 9.57 at 5 years (P < .01) was noted and 90.9% of patients remained satisfied with the operation and would recommend the procedure. There were 2 complications. One patient experienced a traumatic neuroma and another avascular necrosis of the first metatarsal head. The scarf osteotomy is a safe and effective procedure with reproducible and excellent medium-term results.