Klinički rezultati scarf osteotomije
Sažetak
Uvod/Cilj. U Srbiji ima vrlo malo radova u kojima se opisuju klinički rezultati i dugoročni efekti scarf osteotomije (SO). Cilj ove retrospektivne studije bio je da se utvrdi efikasnost SO kod hallux valgus (HV) deformiteta, kao i stepen recidiva i njihovi mogući uzroci. Metode. Studijom su bila obuhvaćena 48 bolesnika (52 stopala) kod kojih je izvršena SO. Prosečno vreme praćenja bilo je 103,9 (63–156) meseci. U cilju kliničke procene rezultata korišćena je skala američkog ortopedskog udruženja za skočni zglob i stopalo (American Orthopedic Foot and Ankle Society – AOFAS) i Vizuelna analogna skala (VAS) bola. U cilju radiografskog utvrđivanja stepena deformiteta, preoperativno i postoperativno su rađene radiografije stopala u stojećoj poziciji i određivani su sledeći parametri: HV ugao (HVU), intermetatarzalni ugao, distalni metatarzalni artikularni ugao i pozicija sezamoida. Rezultati. Vrednosti skora AOFAS povećane su sa 19 (5–45) poena preoperativno na 92 (54–100) poena u trenutku poslednjeg kontrolnog pregleda (p < 0,001). Vrednosti VAS su se značajno poboljšale sa preoperativnih vrednosti 10 (8–10) na 0 (0–6). Prosečna korekcija HVU bila je 24,8°. Stepen recidiva kod bolesnika gde je HVU bio veći od 20° iznosio je 26,9%. Zaključak. Iako je SO dokazana procedura za korekciju HV, ipak dugotrajni rezultati govore u prilog relativno visokog stepena recidiva.
Reference
1. Meyer M. Eine neue modifikation der hallux valgus operation. Zbl Chir 1926; 53: 3265–8. (German)
2. Burutaran JM. Hallux valgus y cortedad anatomica del primer metatarsano (correction quinrusica). Actual Med Chir Pied 1976; 13: 261–6. (Spanish)
3. Borelli AN, Weil LS. Modified Scarf bunionectomy: Our experience in more than 1000 cases. J Foot Surg 1991; 30: 609–22.
4. Barouk LS. Scarf osteotomy for hallux valgus correction. Local anatomy, surgical technique, and combination with other forefoot procedures. Foot Ankle Clin 2000; 5(3): 525–58.
5. Lipscombe S, Molloy A, Sirikonda S, Hennessy MS. Scarf osteotomy for the correction of hallux valgus: midterm clinical outcome. J Foot Ankle Surg 2008; 47(4): 273–7.
6. Bock P, Lanz U, Kröner A, Grabmeier G, Engel A. The scarf osteotomy: a salvage procedure for recurrent hallux valgus in selected cases. Clin Orthop Relat Res 2010; 468(8): 2177–87.
7. Doty JF, Coughlin MJ. Hallux valgus and hypermobility of the first ray: facts and fiction. Int Orthop 2013; 37(9): 1655–60.
8. Swanton E, Mason L, Molloy A. How do I use the scarf osteotomy to rotate the metatarsal and correct the deformity in three dimensions? Foot Ankle Clin 2018; 23(2): 239–46.
9. Bock P, Kluger R, Kristen KH, Mittlböck M, Schuh R, Trnka HJ. The Scarf Osteotomy with Minimally Invasive Lateral Release for Treatment of Hallux Valgus Deformity: Intermediate and Long-Term Results. J Bone Joint Surg Am 2015; 97(15): 1238–45.
10. Fuhrmann RA, Zollinger-Kies H, Kundert HP. Mid-term results of scarf osteotomy in hallux valgus. Int Orthop 2010; 34(7): 981–9.
11. Crevoisier X, Mouhsine E, Ortolano V, Udin B, Dutoit M. The scarf osteotomy for the treatment of hallux valgus deformity: a review of 84 cases. Foot Ankle Int 2001; 22(12): 970–6.
12. Coetzee JC. Scarf osteotomy for hallux valgus repair: the dark side. Foot Ankle Int 2003; 24(1): 29–33.
13. Davies MB, Blundell CM, Marquis CP, McCarthy AD. Interpretation of the scarf osteotomy by 10 surgeons. Foot Ankle Surg 2011; 17(3): 108–12.
14. Jeuken RM, Schotanus MG, Kort NP, Deenik A, Jong B, Hendrickx RP. Long-term follow-up of a randomized controlled trial comparing scarf to Chevron osteotomy in hallux valgus correction. Foot Ankle Int 2016; 37(7): 687–95.
15. Deenik A, Verburg A, Louwerens JW, de Waal Malefijt M, de Bie R. Evidence of treatment algorithms for hallux valgus. JSM Foot Ankle 2016; 1(1): 1003.
16. Hatch DJ, Santrock RD, Smith B, Dayton P, Weil L Jr. Triplane hallux abducto valgus classification. J Foot Ankle Surg 2018; 57(5): 972–81.
17. Okuda R, Kinoshita M, Yasuda T, Jotoku T, Kitano N, Shima H. The shape of the lateral edge of the first metatarsal head as a risk factor for recurrence of hallux valgus. J Bone Joint Surg Am 2007; 89(10): 2163–72.
18. Okuda R, Kinoshita M, Yasuda T, Jotoku T, Kitano N, Shima H. Postoperative incomplete reduction of the sesamoids as a risk factor for recurrence of hallux valgus. J Bone Joint Surg Am 2009; 91(7): 1637–45.
19. Kaufmann G, Sinz S, Giesinger JM, Braito M, Biedermann R, Dammerer D. Loss of Correction After Chevron Osteotomy for Hallux Valgus as a Function of Preoperative Deformity. Foot Ankle Int 2019; 40(3): 287–96.
20. Park CH, Lee W. Recurrence of Hallux Valgus Can Be Predicted from Immediate Postoperative Non-Weight-Bearing Radiographs. J Bone Joint Surg 2017; 99(14): 1190–7.
21. Lai MC, Rikhraj IS, Woo YL, Yeo W, Ng YCS, Koo K. Clinical and Radiological Outcomes Comparing Percutaneous Chevron-Akin Osteotomies vs Open Scarf-Akin Osteotomies for Hallux Valgus. Foot Ankle Int 2018; 39(3): 311–7.
22. Lee M, Walsh J, Smith MM, Ling J, Wines A, Lam P. Hallux Valgus Correction Comparing Percutaneous Chevron/Akin (PECA) and Open Scarf/Akin Osteotomies. Foot Ankle Int 2017; 38(8): 838–46.
23. Samaras D, Gougoulias N, Varitimidis S, Hantes M, Karachalios T, Malizos K, et al. Midterm experience of Scarf osteotomy as a new technique in a General Orthopaedic Department. Foot (Edinb) 2019; 40: 68–75.