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Outcomes after scarf osteotomy with and without Akin osteotomy a retrospective comparative study
Gerhard Kaufmann1, Maximilian Hofmann2, Hanno Ulmer3
1OFZ Innsbruck, Innrain 2 / 3.Stock, 6020, Innsbruck, Austria. gerhard.kaufmann9@chello.at.
Journal of Orthopaedic Surgery and Research
|June 28, 2019
Summary
Adding an Akin osteotomy to a scarf osteotomy significantly reduces hallux valgus recurrence. This combination is particularly recommended for patients with a preoperative proximal to distal phalangeal articular angle exceeding eight degrees.
Area of Science:
- Orthopedic surgery
- Foot and ankle surgery
- Radiology
Background:
- Scarf osteotomy is a common procedure for hallux valgus correction.
- It is frequently combined with an Akin osteotomy.
- Guidelines for combining these procedures are lacking.
Purpose of the Study:
- To evaluate the radiological outcomes of scarf osteotomy.
- To determine the impact of an additional Akin osteotomy on these outcomes.
Main Methods:
- Retrospective comparative study of 184 patients (scarf osteotomy only) and 63 patients (scarf + Akin osteotomy).
- Weight-bearing radiographs analyzed preoperatively and postoperatively at multiple time points up to mean 45.4 months.
- Key radiological parameters included IMA, HVA, DMAA, PDPAA, sesamoid position, and joint congruity.
Main Results:
- Recurrence (HVA > 20°) was significantly lower in the combined group (1.6% vs. 14.7%).
- The Akin osteotomy group showed significantly less loss of HVA correction.
- Patients with preoperative PDPAA > 8° had inferior outcomes with scarf osteotomy alone.
Conclusions:
- Concomitant Akin osteotomy improves radiological outcomes after scarf osteotomy for hallux valgus.
- A preoperative PDPAA greater than 8° indicates the recommendation for an additional Akin osteotomy.
Keywords:
Akin osteotomyHallux valgus deformityPDPAAPreoperative deformityProximal to distal phalangeal articular angleRadiological outcomeScarf osteotomyMore Related Videos
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