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재발한 무지 외반증의 치료로 시행한 Scarf 절골술

Scarf Osteotomy for the Treatment of Recurred Hallux Valgus

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초록

Purpose: Recurrence is one of the most common complications after primary correction for hallux valgus deformities. The purpose of this study was to evaluate the usefulness of Scarf osteotomy with axial decompression in the treatment of recurrent hallux valgus. Materials and Methods: From April 2006 to April 2011, 14 cases (12 patients) of recurrent hallux valgus were managed with shortening Scarf osteotomy. Preoperative and postoperative radiographs were reviewed for the measurement of the hallux valgus angle (HVA), intermetatarsal angle (IMA), and the amount of the 1st metatarsal shortening. Clinical outcomes including the visual analogue scale (VAS), the AOFAS score, and the range of motion [ROM] of the 1st metatarsophalangeal (MTP) joint were evaluated. Results: The mean HVA decreased from 27.9 degrees to 5.2 and the mean IMA decreased from 12.9 to 3.4. The mean VAS improved from 5.3 to 0.3 and the mean AOFAS score improved from 41 to 90. The mean amount of the 1st metatarsal shortening was 3.4 mm (2-5). The mean ROM of the 1st MTP joint improved from 22 degrees (15-35) to 68 (55-75). Conclusion: Scarf osteotomy associated with axial decompression can be a useful revision procedure for the treatment of recurrent hallux valgus deformity

Abstract

Purpose: Recurrence is one of the most common complications after primary correction for hallux valgus deformities. The purpose of this study was to evaluate the usefulness of Scarf osteotomy with axial decompression in the treatment of recurrent hallux valgus. Materials and Methods: From April 2006 to April 2011, 14 cases (12 patients) of recurrent hallux valgus were managed with shortening Scarf osteotomy. Preoperative and postoperative radiographs were reviewed for the measurement of the hallux valgus angle (HVA), intermetatarsal angle (IMA), and the amount of the 1st metatarsal shortening. Clinical outcomes including the visual analogue scale (VAS), the AOFAS score, and the range of motion [ROM] of the 1st metatarsophalangeal (MTP) joint were evaluated. Results: The mean HVA decreased from 27.9 degrees to 5.2 and the mean IMA decreased from 12.9 to 3.4. The mean VAS improved from 5.3 to 0.3 and the mean AOFAS score improved from 41 to 90. The mean amount of the 1st metatarsal shortening was 3.4 mm (2-5). The mean ROM of the 1st MTP joint improved from 22 degrees (15-35) to 68 (55-75). Conclusion: Scarf osteotomy associated with axial decompression can be a useful revision procedure for the treatment of recurrent hallux valgus deformity

참고문헌 (13)

  1. Duan X, "Salvage of recurrence after failed surgical treatment of hallux valgus", Arch Orthop Trauma Surg, 132, pp.477~485 (2012)
  2. Bock P, "The Scarf osteotomy : a salvage procedure for recurrent hallux valgus in selected cases", Clin Orthop Relat Res, 468, pp.2177~2187 (2010)
  3. Robinson AH, "Modern concepts in the treatment of hallux valgus", J Bone Joint Surg Br, 87, pp.1038~1045 (2005)
  4. Coughlin MJ, "Surgery of the Foot and Ankle", pp.183~362 (2007), Mosby
  5. Coughlin MJ, "Arthrodesis of the first metatarsophalangeal joint as salvage for the failed Keller procedure", J Bone Joint Surg Am, 69, pp.68~75 (1987)
  6. Grimes JS, "First metatarsophalangeal joint arthrodesis as a treatment for failed hallux valgus surgery", Foot Ankle Int, 27, pp.887~893 (2006)
  7. Kitaoka HB, "Arthrodesis versus resection arthroplasty for failed hallux valgus operations", Clin Orthop Relat Res, pp.208~214 (1998)
  8. Machacek F, Jr., "Salvage of a failed Keller resection arthroplasty", Bone Joint Surg Am, 86-A, pp.1131~1138 (2004)
  9. Vienne P, "Metatarsophalangeal joint arthrodesis after failed Keller-Brandes procedure", Foot Ankle Int, 27, pp.894~901 (2006)
  10. Wu KK, "First metatarsophalangeal fusion in the salvage of failed hallux abducto valgus operations", J Foot Ankle Surg, 33, pp.383~395 (1994)
  11. Coetzee JC, "The Lapidus procedure as salvage after failed surgical treatment of hallux valgus: a prospective cohort study", J Bone Joint Surg Am, 85-A, pp.60~65 (2003)
  12. Kitaoka HB, "Salvage treatment of failed hallux valgus operations with proximal first metatarsal osteotomy and distal soft-tissue reconstruction", Foot Ankle Int, 19, pp.127~131 (1998)
  13. Coetzee JC, "The Lapidus procedure as salvage after failed surgical treatment of hallux valgus. Surgical technique", J Bone Joint Surg Am, 86-A(1), pp.30~36 (2004)

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