[Modification of Scarf osteotomy for the treatment of hallux valgus]

To show that the modified scarf osteotomy for hallux valgus surgery provides a greater basal contact surface, which results in more stability and less complications for the management of the metatarsus primus varus, and helps define its indications.

Longitudinal, ambispective trial conducted between 2005 and January 2012 in patients with hallux valgus and metatarsus primus varus, with a statistical analysis using Student's T test to compare the preoperative and postoperative values of the American Orthopaedic Foot & Ankle Society scale.

58 modified scarf osteotomies were performed in 46 patients; there were 12 bilateral patients. Mean age was 45 years; 43 patients were females (93.47%) and 3 were males (6.53%). Of the 58 scarf osteotomies, 54 feet did well (93.10%), 3 feet had relapse of the deformity (5.17%), and one had arthrosis of the metatarso-phalangeal joint (1.72%). The American Orthopaedic Foot & Ankle Society classification increased significantly from 40.65 to 82.26 (p < 0.0001).

The modified scarf osteotomy provides greater contact surface in its inverted basal aspect, thus providing more basal stability and therefore less complications. It is therefore a safe procedure capable of correcting the essential components of the hallux valgus and the metatarsus primus varus, provided the indications are precise, like cuneometatarsal instability, joint stiffness and hindfoot alteration, as this leads to hallux valgus relapse.