소족지 중족골통을 동반한 무지 외반증에서의 변형 스카프 절골술 (Modified Scarf Osteotomy for Hallux Valgus with Lesser Metatarsalgia)

서지정보

· 발행기관 : 대한족부족관절학회
· 수록지 정보 : 대한족부족관절학회지 / 12권 / 2호 / 134 ~ 139페이지
· 저자명 : 정진화, 정현우, 주인탁

초록

Purpose: The purpose of this study was to evaluate the radiological and clinical results of modified scarf osteotomy
for hallux valgus with lesser metatarsalgia.
Materials and Methods: Total 19 patients (24 feet) were reviewed by medical records and radiographs. All patients were
female and the mean age at the time of operation was 46.4 years. The mean follow-up time was 14.8 months. We modified
original scarf osteotomy by adding the procedure of closing wedge osteotomy at the medial side of distal fragment
for achieving of the supination of the first metatarsal head. Additionally, Akin osteotomy of the first proximal phalanx was
done in 16 patients (20 feet) and no lesser metatarsal operation was done. First-second intermetatarsal, hallux valgus and
distal metatarsal articular angles were analyzed radiologically before and after the operation. And 3-dimensional CT
was used to evaluate the supination of the first metatarsal head. Clinical results were assessed by American
Orthopaedic Foot and Ankle Society (AOFAS) score and persistence of lesser metatarsalgia.
Results: First-second intermetatarsal and hallux valgus angles were reduced from the mean pre-operative values of 14.2°
and 32.5° to 8° and 12.5°, respectively, 12 months after the operation. And the supination of the first metatarsal head was
confirmed by 3-dimensional CT. The mean AOFAS score improved from 41.4 points pre-operatively to 87.2 points at
follow-up. Lesser metatarsalgia still remained in 2 patients (2 feet).
Conclusion: Modified scarf osteotomy would be an effective surgical procedure, especially, for achieving downward
displacement and supination of the first metatarsal head in hallux valgus with lesser metatarsalgia.

영어초록

Purpose: The purpose of this study was to evaluate the radiological and clinical results of modified scarf osteotomy
for hallux valgus with lesser metatarsalgia.
Materials and Methods: Total 19 patients (24 feet) were reviewed by medical records and radiographs. All patients were
female and the mean age at the time of operation was 46.4 years. The mean follow-up time was 14.8 months. We modified
original scarf osteotomy by adding the procedure of closing wedge osteotomy at the medial side of distal fragment
for achieving of the supination of the first metatarsal head. Additionally, Akin osteotomy of the first proximal phalanx was
done in 16 patients (20 feet) and no lesser metatarsal operation was done. First-second intermetatarsal, hallux valgus and
distal metatarsal articular angles were analyzed radiologically before and after the operation. And 3-dimensional CT
was used to evaluate the supination of the first metatarsal head. Clinical results were assessed by American
Orthopaedic Foot and Ankle Society (AOFAS) score and persistence of lesser metatarsalgia.
Results: First-second intermetatarsal and hallux valgus angles were reduced from the mean pre-operative values of 14.2°
and 32.5° to 8° and 12.5°, respectively, 12 months after the operation. And the supination of the first metatarsal head was
confirmed by 3-dimensional CT. The mean AOFAS score improved from 41.4 points pre-operatively to 87.2 points at
follow-up. Lesser metatarsalgia still remained in 2 patients (2 feet).
Conclusion: Modified scarf osteotomy would be an effective surgical procedure, especially, for achieving downward
displacement and supination of the first metatarsal head in hallux valgus with lesser metatarsalgia.

참고자료

· 없음