Work

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

Year: 2025

Type: article

Abstract: 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. LEVEL OF EVIDENCE: III; Retrospective cohort study.

Source: Orthopaedics & Traumatology Surgery & Research

DOI: 10.1016/j.otsr.2025.104563

Authors: Galdéric Roblot, Wilfrid Graff

Institutions: Centre Hospitalier Universitaire Amiens-Picardie, Groupe Hospitalier Diaconesses Croix Saint-Simon, Hôpital des Diaconesses

Language: English

Topic: Foot and Ankle Surgery

Subfield: Orthopedics and Sports Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,820