Scarf osteotomy outcomes

NewsBot · Jul 3, 2025

Comparison of clinical efficacy of transmetatarsal incision and lateral soft tissue release of medial incision combined with Scarf osteotomy in the treatment of moderate to severe hallux valgus
Feng-Ping Wen et al
Zhongguo Gu Shang. 2025 Jun 25;38(6):559-65

Objective: To compare clinical efficacy of intermetatarsal incision and lateral soft tissue release of medial incision combined with Scarf osteotomy in treating moderate to severe hallux valgus (HV).

Methods: A retrospective analysis was conducted on clinical data of 42 patients with moderate to severe HV admitted from January 2022 to December 2022. According to different incisions, the patients were divided into medial incision group with 22 patients (22 feet) and intermetatarsal incision group with 20 patients (20 feet). In medial incision group, there were 3 males and 19 females, aged from 40 to 69 years old with an average of (55.0±11.4) years old;body mass index (BMI) ranged from 21 to 29 kg·m-2 with an average of (25.2±2.1) kg·m-2;the courses of disease ranged from 8 to 16 years with average of (12.0±2.2) years;11 patients with moderate deformity and 11 patients with severe deformity. In transplantar incision group, there were 3 males and 17 females, aged from 39 to 68 years old with an average of (53.0±7.5) years old;BMI ranged from 20 to 28 kg·m-2 with an average of (24.8±1.9) kg·m-2;the courses of disease ranged from 9 to 17 years with an average of (14.0±3.1) years;9 patients with moderate deformity and 11 patients with severe deformity. Hallux valgus angle (HVA) and the first-second intermetatarsal angle (IMA), American Orthopaedic Foot and Ankle Society (AOFAS) forefoot scores and complications between two groups before operation and 12 months after operation were observed and compared.

Results: All patients were successfully completed the surgery and were followed up for 12 to 15 months with an average of (13.52±1.65) months. There were no statistically significant difference in HVA and IMA between two groups before operation and 12 months after operation (P>0.05). AOFAS forefoot scores of medial incision group before operation and 12 months after operation were (45.0±6.8) and (86.0±6.7) respectively, and those of transmetatarsal incision group were (46.0±7.4) and (83.0±7.5) respectively. Postoperative AOFAS forefoot scores between two groups at 12 months were statistically significant compared with those of before operation (P<0.01). According to AOFAS forefoot scores, 8 patients got excellent result, 14 good in medial incision group;while 6 excellent and 14 good in transplantar incision group. At 12 months, postoperative AOFAS forefoot score of functional score of in medial incision group(38.0±2.5), was better than that in transplantar incision group (34.0±2.2), and the difference was statistically significant (P<0.05). One patient in medial incision group occurred HV deformity, mild numbness occurred in 3 toes in transplantar incision group, and 3 patients were dissatisfied with scar. No complications such as infection, nonunion of bones or ischemic necrosis of metatarsal heads occurred in either group.

Conclusion: Both intermetatarsal incision and lateral soft tissue release of medial incision combined with Scarf osteotomy can effectively treat moderate to severe HV. The functional recovery after medial incision is better than that after intermetatarsal incision.
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NewsBot · Aug 23, 2025

Scarf osteotomy combined with akin osteotomy for the treatment of patients with moderate hallux valgus: a retrospective study combining plantar pressure testing and gait analysis
Peng Lu, Songchuan S et al
Source

Background

Hallux Valgus (HV) not only results in deformities in the appearance of the foot but also induces pain and difficulties in walking, significantly affecting the quality of life of patients. This study utilises three-dimensional (3D) scanners and wearable gait sensors to precisely measure foot arch indices, plantar pressure distribution, and gait parameters, aiming to comprehensively assess the efficacy of Scarf osteotomy in conjunction with Akin osteotomy, thus providing scientific evidence for clinical treatment.
Methods

This retrospective study comprised a cohort of 60 patients diagnosed with moderate HV who underwent a Scarf osteotomy in conjunction with an Akin osteotomy during the period from December 2021 to December 2022. Data collection and follow-up evaluations were conducted both preoperatively and at the 12-month postoperative mark. The primary observational parameters included the Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), and Distal Metatarsal Articular Angle (DMAA). Clinical assessment measures encompassed the Visual Analogue Scale (VAS) and the Japanese Society for Surgery of the Foot (JSSF) HV scale. Additionally, foot arch parameters, gait cycle-related metrics, and plantar pressure distribution were obtained utilising 3D scanning technology and wearable sensor devices.
Results

All patients underwent a minimum follow-up period of twelve months, with an average clinical healing duration of 8.20 weeks. Postoperatively, there was a significant reduction in the VAS score, alongside a significant increase in the JSSF score. The HVA, IMA, and DMAA angles all demonstrated significant improvement. Postoperatively, the foot arch index exhibited a decline, the step deviation angle was diminished, the midstance time percentage experienced an increase, and there was an enhancement in plantar pressure distribution. Patients expressed satisfaction with both the treatment outcomes and the aesthetic results.
Conclusion

The combination of Scarf and Akin osteotomy significantly improved foot arch morphology and gait parameters in HV patients, effectively alleviating pain and enhancing walking stability.
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NewsBot · Aug 24, 2025

Scarf osteotomy combined with akin osteotomy for the treatment of patients with moderate hallux valgus: a retrospective study combining plantar pressure testing and gait analysis
Peng Lu et al
BMC Musculoskelet Disord. 2025 Aug 18;26(1):800. doi: 10.1186/s12891-025-09056-2.

Background: Hallux Valgus (HV) not only results in deformities in the appearance of the foot but also induces pain and difficulties in walking, significantly affecting the quality of life of patients. This study utilises three-dimensional (3D) scanners and wearable gait sensors to precisely measure foot arch indices, plantar pressure distribution, and gait parameters, aiming to comprehensively assess the efficacy of Scarf osteotomy in conjunction with Akin osteotomy, thus providing scientific evidence for clinical treatment.
Methods: This retrospective study comprised a cohort of 60 patients diagnosed with moderate HV who underwent a Scarf osteotomy in conjunction with an Akin osteotomy during the period from December 2021 to December 2022. Data collection and follow-up evaluations were conducted both preoperatively and at the 12-month postoperative mark. The primary observational parameters included the Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), and Distal Metatarsal Articular Angle (DMAA). Clinical assessment measures encompassed the Visual Analogue Scale (VAS) and the Japanese Society for Surgery of the Foot (JSSF) HV scale. Additionally, foot arch parameters, gait cycle-related metrics, and plantar pressure distribution were obtained utilising 3D scanning technology and wearable sensor devices.

Results: All patients underwent a minimum follow-up period of twelve months, with an average clinical healing duration of 8.20 weeks. Postoperatively, there was a significant reduction in the VAS score, alongside a significant increase in the JSSF score. The HVA, IMA, and DMAA angles all demonstrated significant improvement. Postoperatively, the foot arch index exhibited a decline, the step deviation angle was diminished, the midstance time percentage experienced an increase, and there was an enhancement in plantar pressure distribution. Patients expressed satisfaction with both the treatment outcomes and the aesthetic results.

Conclusion: The combination of Scarf and Akin osteotomy significantly improved foot arch morphology and gait parameters in HV patients, effectively alleviating pain and enhancing walking stability.
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NewsBot · Oct 10, 2025

Finite element analysis of Scarf osteotomy for precise treatment of hallux valgus
Min Zhang et al
J Orthop. 2025 Jan 17:67:132-139.

Background: The treatment of hallux valgus is currently in face of many challenges in clinical practice. Although conventional surgical procedures can correct deformities to a certain extent, some key parameters such as osteotomy displacement and angle are often difficult to determine, leading to increased uncertainty in surgical outcomes and a relatively high incidence of postoperative complications.

Objective: Hallux valgus is a common foot deformity that often leads to pain, difficulty in walking, and other health problems, seriously affecting the quality of life of patients. In order to provide patients with more precise treatment, we aimed to simulate the Scarf osteotomy for the treatment of hallux valgus using the finite element method, and comparatively analyze the mechanical performance indicators under different distal osteotomy displacements. We hoped to provide scientific and reasonable treatment plans for clinical practice and better treatment outcomes for patients.

Methods: A volunteer with moderate hallux valgus was selected as the research subject in this study. Preoperative plantar pressure test was conducted, and the CT data of the patient's affected foot was collected to create the finite element model using finite element software. After verifying the validity of the model, it was used to simulate the translational Scarf osteotomy under different settings. Specifically, the distal end of the bone fragment was pushed outwards by varying distances (2 mm, 4 mm, 6 mm, and 8 mm) and was fixed with screws. The maximum Von Mises stresses on the first to fifth metatarsal bones, the sole and the heel under four different surgical settings were compared with the preoperative values, and the changes in the maximum Von Mises stress on the screws were examined.

Results: When the distal end of the bone fragment was pushed outwards by 6 mm, the maximum Von mises stress on the first metatarsal bone (9.4711 MPa) reached its highest value, while the maximum Von mises stresses on the second and third metatarsal bones (0.34062 MPa and 1.6246 MPa, respectively) and on the screws (40.99 MPa) were at the lowest values. The maximum plantar pressure detected during static test was 0.292 MPa, while the maximum plantar stress observed in the finite element model was 0.25733 MPa, indicating comparable values between the two.

Conclusions: Based on precise and customized preoperative design and finite element analysis, it was found that the Scarf osteotomy with the distal end of the bone fragment pushed outwards for 6 mm could yield the best treatment effect for hallux valgus. Under this setting, the stress on the first metatarsal bone was the highest, while the stresses on the second and third metatarsal bones were the lowest, suggesting that it can relieve the stress on lateral metatarsal bones and improve the stress distribution of the forefoot. Overall, Scarf osteotomy under 6 mm setting can effectively correct hallux valgus deformity, reduce the incidence of metastatic plantar pain and prevent the recurrence of metastatic plantar pain after surgery. By improving the patient's plantar stress distribution, this surgical setting is expected to provide better clinical outcomes.
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NewsBot · Dec 6, 2025

Long-Term Radiographic Outcomes of Scarf Osteotomy in the Treatment of Hallux Valgus: Review of 237 Cases with an Average Follow-Up of 12 Years
Galdéric Roblot, Wilfrid Gaff
Orthop Traumatol Surg Res. 2025 Dec 3:104563.

Background: Although surgical correction of hallux valgus (HV) is the most common procedure in foot surgery, nearly one-third of patients express dissatisfaction, primarily due to lack of correction or recurrence. Reported recurrence rates in the literature vary widely, ranging from 2% to 72%. Accurately estimating the prevalence of recurrence is challenging due to the lack of a consensus on its definition and the heterogeneity of the surgical techniques studied. While recurrence can be a slowly progressive phenomenon, most published cohorts have a postoperative follow-up limited to only one or two years. The aims of this study were 1) to assess the radiologic recurrence rate of HV following Scarf osteotomy, with a minimum follow-up of 8 years. 2) to identify factors associated with recurrence.

Hypothesis: At long-term follow up, hallux valgus recurrence is common.

Materials and methods: A retrospective observational study was conducted, including patients who underwent Scarf osteotomy for hallux valgus correction between January 2001 and January 2014. During this period, 3450 patients underwent Scarf osteotomy for HV correction. Among them, 237/3450 (6.9%) had complete medical records and were included in the analysis. The primary outcome was radiologic recurrence, defined as a hallux valgus angle (HVA) exceeding 20 degrees.

Results: At a mean follow-up of 12.2±2.77 years, the recurrence rate was 15.2% (36/237). Mean HVA was 10.53±8 degrees. The identified factors associated with recurrence included the severity of the preoperative deformity (HVA, p< 0.001; sesamoid position, p<0.001; Intermetatarsal angle, p = 0.018) and the quality of postoperative correction (HVA, p<0.001; sesamoid position, p = 0.0031 and MTP1 joint congruency, p = 0.0037).

Discussion: Over the long term, recurrence of hallux valgus following Scarf osteotomy is a frequent phenomenon, particularly in patients presenting with more severe preoperative deformities. These results may allow for appropriate patient information about long-term recurrence before surgery, even though the recurrence rate is likely underestimated, since only 6.9% of patients benefited from long-term follow-up in this retrospective study.
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NewsBot · Dec 18, 2025

Clinical Efficacy of the Reversed 'L'-Shaped Osteotomy Combined with Lateral Soft Tissue Release in the Treatment of Moderate to Severe Hallux Valgus: A Comparative Study with Scarf Osteotomy
Wei Qi et al
J Foot Ankle Surg. 2025 Dec 15:S1067-2516(25)00362-X.

Objective: The purpose of this study was to evaluate the clinical efficacy of the "Reversed L" osteotomy combined with lateral soft tissue release for moderate to severe hallux valgus.

Methods: A retrospective analysis was performed on the clinical and radiographic data in patients diagnosed with moderate to severe hallux valgus who underwent surgical treatment between January 2023 and January 2025. Patients were categorized into two groups based upon technique: the ReveL group (ReveL group: n=244 feet) and the Scarf group (Scarf group: n=234 feet). Clinical and radiological parameters were compared between two groups pre and post operatively. The clinical and radiological outcomes of the two groups were rigorously studied assessing both diagnostic accuracy and treatment efficacy.

Result: All patients successfully underwent surgery and completed the follow-up. Compared with the Scarf group, the ReveL group exhibited a significantly shorter operation time (70±13 vs. 90±21 minutes, P=0.038). Statistically significant differences were noted in all preoperative and postoperative clinical and imaging parameters within each group (all P<0.001). Postoperatively, statistically significant differences were observed between the two groups in hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), and visual analog scale (VAS)(P<0.05). Specifically, the postoperative HVA and DMAA values in the ReveL group were significantly lower than those in the Scarf group (P <0.05), in addition, the postoperative VAS score in the ReveL group was significantly lower than in the Scarf group (P<0.01).

Conclusion: Compared to Scarf osteotomy, ReveL osteotomy demonstrates superior correction of metatarsal rotational deformity and provides more significant improvement in moderate to severe hallux valgus. Therefore, it serves as an effective and reliable surgical option for correcting deformities in this patient population.
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Scarf osteotomy outcomes

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Scarf osteotomy outcomes

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Mitchel vs Scarf osteotomy

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Lapidus or scarf surgery for bunion?

Saggital scarf procedure

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scarf bunionectomy and still nwb wondering who else had this and when do you get walking boot?

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Share This Page

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