Ever more common procedure for Hallux Valgus correction



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Ever more common procedure for Hallux Valgus correction (particularly amongst F&A community)

  • Ever more common procedure for Hallux Valgus correction (particularly amongst F&A community)

  • Patients frequently ask success rates in clinic before committing to surgery

  • To examine the role of Akin osteotomy

  • To audit outcomes of Senior surgeons practice



Junior author identified all patients undergoing Scarf osteotomy in NHS (CRH) April 2008-Mar 2010

  • Junior author identified all patients undergoing Scarf osteotomy in NHS (CRH) April 2008-Mar 2010

  • Patients contacted via telephone numbers registered in PAS system

  • Asked a simple questionnaire of 4 questions (see next slide)

  • Results recorded using Microsoft Excel



Q1. degree of satisfaction

  • Q1. degree of satisfaction

  • How satisfied are you with the surgery you have had for your bunion? (Very satisfied- satisfied-neutral- unsatisfied – very unsatisfied)

  • Q2.if the other foot

    • If you had the same problem with a painful bunion on the other foot would you have the same surgery on that foot ?
  • Q3.if a friend or a relative

    • Would you recommend the surgery to a friend who had a similar problem with a bunion?
  • Q4.complications

  • Have you had any complication from this surgery?



April 2008-Mar 2010

  • April 2008-Mar 2010

    • Total patients identified = 64
    • 83 scarfs in 64 patients ( 19 bilateral)
    • Total patients contactable = 42
    • 53 scarfs in 42 patients (11 bilateral)
    • Age range 17 – 89years ( mean age = 52 )
    • F: M = 54:10 = 5.4 : 1
    • Number of Akin + Scarf = 30 (36%)


  • Results







Q 3: recommending the surgery



  • Infection

    • 3 (superficial)
    • All resolved at 2 weeks with oral antibiotics
  • No Chronic regional pain syndrome



>83% patients are satisfied with surgery at CRH in this single surgeon series

  • >83% patients are satisfied with surgery at CRH in this single surgeon series

  • Only 2 patients were unsatisfied(4.7%)

  • 88 % would recommend this procedure to a friend or undergo it again

  • >95% were either very satisfied, satisfied or neutral



  • Reproducible operation

  • Powerful 3D correction in right hands

  • Minimal complications consistent with other forms of corrective osteotomy



Scarf procedure is successful , safe and reproducible correction of Hallux Valgus

  • Scarf procedure is successful , safe and reproducible correction of Hallux Valgus

  • >83% of CRH / HRI patients satisfied with this surgery in this single surgeon series

  • It can take 9-12 months for patients to fully recover from forefoot surgery, particularly swelling





With thanks to PAS office, SWS secretary , audit department and enquiry desk for their help in collecting and presenting this data

  • With thanks to PAS office, SWS secretary , audit department and enquiry desk for their help in collecting and presenting this data




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