Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Paediatrics
Abstract number: 24154
SCARF-AKIN OSTEOTOMY FOR HALLUX VALGUS IN JUVENILE AND
ADOLESCENT PATIENTS
Yuvraj AGRAWAL, Sunil BAJAJ, Mark FLOWERS
Sheffield Children's Hospital NHS Trust, Sheffield (UNITED KINGDOM)
Aim: We report the radiological outcomes of Scarf- Akin osteotomy in the treatment of
juvenile and adolescent hallux valgus. Methods: A retrospective review of the
patients who underwent a Scarf - Akin osteotomy between the period of February
2002 and August 2007. The only indication for surgery in all cases was moderate to
severe symptomatic hallux valgus. The pre- and post-operative intermetatarsal angle
(IMA), hallux valgus angle (HVA), distal metatarsal articular angle (DMAA) and ratio
of the length of first metatarsal to that of the second metatarsal were determined.
Results: 34 patients (57 feet) underwent Scarf-Akin Osteotomy for moderate to
severe hallux valgus. Average age of the patients at operation was 12.9 years. Pre-
and postoperative radiographs of these patients were evaluated. Three patients with
non-weight-bearing radiographs were excluded. The six weeks post operative
radiographs showed a significant improvement of the IMA, HVA and DMAA in all the
54 feet. This improvement was maintained in 20 patients (32 feet) at the last follow
up. Recurrence was noted in 14 patients (22 feet) of which 7 patients (10 feet)
underwent revision surgery. One patient (both feet) underwent 2nd revision surgery.
Discussion: Hallux valgus has been reported to affect 22 -36% of adolescents with a
reported incidence of recurrence 30 - 40 %. Radiological recurrence rate in our series
was 40%, but less than half were symptomatic enough to require a revision surgery.
We report a high recurrence rate in hallux valgus surgery in children and hence
suggest postponement of correction until skeletal maturity.
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