Modified scarf osteotomy for hallux valgus

Abstract

Category: Bunion Introduction/Purpose: To compare the elemental characteristics through a finite element (FE) model with an anatomically realistic geometry and structure of the metatarsophalangeal (MTP) joint. This model will estimate the biomechanical features and correction differences regarding dynamic loading and incidences of troughing. Methods: We retrospectively evaluated 40 patients who had undergone a modified rotational scarf osteotomy to correct for moderate to severe hallux valgus (HV) at our institution between January 2009 and December 2015. To compare the results and the elemental characteristics, we built a finite element model that included an anatomically realistic geometry and structure of the metatarsophalangeal (MTP) joint and estimated the biomechanical features and correction differences on dynamic loading as well as incidences of troughing. Results: Although the radiological outcomes remained unchanged within the first three months and moderately worsened over time as measured at the final radiographical assessment, all patients were satisfied with the results, including their visual analysis score (VAS) and American Orthopedic Foot & Ankle Society (AOFAS) score. The rates of troughing and recurrence were remarkably lower in our pilot because of the innate stability of the modified rotated fixation. Conclusion: Our pilot findings suggest that the modified rotational scarf osteotomy procedure offers sufficient stability, optimal corrections and variable options.