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무지 외반증 환자에서 평행 변형 스카프 절골술을 이용한 치료 결과

Treatment Results of Hallux Valgus Deformity by Parallel-Shaped Modified Scarf Osteotomy

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Purpose: The purpose of this study was to evaluate the clinical and radiographic results of the parallel-shaped modified Scarf osteotomy which is performed the Scarf osteotomy parallel to the shaft of the 1st metatarsal bone for hallux valgus deformities. Materials and Methods: We retrospectively reviewed 43 patients who had been treated by the parallel-shaped modified Scarf osteotomy for hallux valgus deformities between January 2006 and March 2011. We evaluated the results after this Scarf osteotomy with respect American Orthopaedic Foot & Ankle Society (AOFAS) scores, radiologic results by comparing intermetatarsal angle between 1stand 2nd metatarsal bones and hallux valgus angle. Results: We checked out the pre-operational and post-operational radiologic evaluation of intermetatarsal angle and hallux valgus angle between 1st and 2nd metatarsal bones. The mean AOFAS scores improved from 63.5 to 88.5. At final follow up, The hallux valgus angle improved from 31.4° (16-52) to 9.0° (3-13) and the intermetatarsal angle improved from 18.6° (12-30) to 9.3° (6-12) postoperatively. There was no case of major complications included recurrence of valgus deformity, correction or fixation failure and stress fractures. Conclusion: Our results suggest the our parallel-shaped modified Scarf osteotomy produces improved AOFAS scores, and effective correction of hallux valgus deformities. Our Scarf technique of osteotomy which is performed in parallel to the metatarsal bone minimizes the need for skill while more reliable and obtaining good correction and avoids associated complications.

Abstract

Purpose: The purpose of this study was to evaluate the clinical and radiographic results of the parallel-shaped modified Scarf osteotomy which is performed the Scarf osteotomy parallel to the shaft of the 1st metatarsal bone for hallux valgus deformities. Materials and Methods: We retrospectively reviewed 43 patients who had been treated by the parallel-shaped modified Scarf osteotomy for hallux valgus deformities between January 2006 and March 2011. We evaluated the results after this Scarf osteotomy with respect American Orthopaedic Foot & Ankle Society (AOFAS) scores, radiologic results by comparing intermetatarsal angle between 1stand 2nd metatarsal bones and hallux valgus angle. Results: We checked out the pre-operational and post-operational radiologic evaluation of intermetatarsal angle and hallux valgus angle between 1st and 2nd metatarsal bones. The mean AOFAS scores improved from 63.5 to 88.5. At final follow up, The hallux valgus angle improved from 31.4° (16-52) to 9.0° (3-13) and the intermetatarsal angle improved from 18.6° (12-30) to 9.3° (6-12) postoperatively. There was no case of major complications included recurrence of valgus deformity, correction or fixation failure and stress fractures. Conclusion: Our results suggest the our parallel-shaped modified Scarf osteotomy produces improved AOFAS scores, and effective correction of hallux valgus deformities. Our Scarf technique of osteotomy which is performed in parallel to the metatarsal bone minimizes the need for skill while more reliable and obtaining good correction and avoids associated complications.

참고문헌 (13)

  1. 정진화, "소족지 중족골통을 동반한 무지 외반증에서의 변형 스카프 절골술", 대한족부족관절학회지, 12(2), pp.134~139 (2008), 대한족부족관절학회
  2. Dobson MH, "Modern concepts in the treatment of hallux valgus", J Bone Joint Surg, 88, pp.276~ (2006)
  3. Joseph TN, "Decision making in the treatment of hallux valgus", Bull NYU Hosp Jt Dis, 65, pp.19~23 (2007)
  4. Barouk LS, "Scarf osteotomy of the first metatarsal in the treatment of hallux valgus", Foot Disases II, 2, pp.35~48 (1995)
  5. Barouk LS., "Scarf osteotomy for hallux valgus correction. Local anatomy, surgical technique, and combination with other forefoot procedures", Foot Ankle Clin, 5, pp.525~528 (2000)
  6. Barouk LS, "Forefoot reconstruction. 2nd ed", pp.19~73 (2005), Springer- Verlag
  7. Weil LS, "Scarf osteotomy for correction of hallux valgus. Historical perspective, surgical technique, and results", Foot Ankle Clin, 5, pp.559~580 (2000)
  8. Seide HW, "Tailor’s bunion: results of a Scarf osteotomy for the correction of an increased intermetatarsal IV", V angle. A report on ten cases with a 1-year follow up, 2001, pp.121, 166~169
  9. Wagner A, "Early results of scarf osteotomies using differentiated therapy of hallux valgus", Foot and Ankle Surgery, 6, pp.105~112 (2000)
  10. Berg RP, "Scarf osteotomy in hallux valgus : a review of 72 cases", Acta Orthop Belg, 73, pp.219~223 (2007)
  11. Duke HF, "Rotational Scarf(Z)osteotomy bunioectomy for correction of high intermetatarsal angles", J Am Podiar Med Assoc, 82, pp.352~360 (1992)
  12. Kramer J, "The modified Scarf bunioectomy", J Foot Surg, 31, pp.360~367 (1992)
  13. Young KW, "Scarf(Z)osteotomy of the first metatarsal shaft in the treatment of hallux valgus", J Korean Soc Foot Surg, 7, pp.157~165 (2003)

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