Moderate to Severe Hallux Valgus Deformities. Surgical treatment with SCARF Osteotomy Technique.
AJTES Vol 6, No 1, January 2022
Julian Ruci et al


metatarsal bone
restore deformity

How to Cite

Ruci, J., & Gjika, E. (2022). Moderate to Severe Hallux Valgus Deformities. Surgical treatment with SCARF Osteotomy Technique. Albanian Journal of Trauma and Emergency Surgery, 6(1), 989-994.


Introduction; Many procedures are described in the literature for the surgical management of hallux valgus. There are over 130 surgical procedures described. There is ever rising enthusiasm among orthopedic surgeons regarding diaphyseal osteotomy ever since Burutaran described the procedure in 1973. We report our experience of treating severe cases of Hallux Valgus deformity with a SCARF osteotomy at the last three years' follow-up, at patients diagnosed and operated in the University Hospital of Trauma, from January 2015 - February 2018. The technique we are presenting provides the correction of moderate to severe hallux valgus deformities.
Material and Methods: Correction of hallux valgus deformities was achieved using a Z-step osteotomy cut to realign the first metatarsal bone. A retrospective analysis was undertaken in 38 consecutive patients (54 feet).  All results were analyzed by clinical examination, a questionnaire including the AOFAS forefoot score, and modified, and plain roentgenograms.
Results: Hallux valgus and intermetatarsal angle improved at mean 19.6° and 6.9°, respectively. The mean forefoot score improved from 50.1 to 91 points out of 100 possible points. Satisfactory healing time was expressed by an average return back to their attitude of 6-12 weeks, without including physiotherapy. Persistence or recurrence of hallux valgus was seen in 3 patients (8%). The complication rate was 5.4% including superficial wound infection, atrophy of the muscles, and traumatic dislocation of the distal fragment.
Conclusion: Scarf osteotomy is a powerful and versatile procedure to correct hallux valgus deformity,  and provides a predictable and satisfying result. Scarfs are not considered as a single osteotomy but as a combination of several procedures and displacement in several planes is possible.
Julian Ruci et al


Akin, OF: The treatment of hallux valgus: a new operative procedure and its results. Med Sentinel 33:678-679, 1925

K.H. Kristen, C. Berger, S. Stelzig, E. Thalhammer, M. Posch, A. Engel The Scarf osteotomy for Hallux Valgus Vienna, Austria FOOT & ANKLE INTERNATIONAL Copyright © 2002 by the American Orthopaedic Foot & Ankle Society, Inc

Barouk, LS: The first metatarsal Scarf osteotomy associated with the first phalanx osteotomy in the hallux valgus treatment. Extrait de medicine et chirurgie du pied. EFORT, Foot and ankle

speciality day: 133-160, 1993

Barouk, LS: Scarf osteotomy of the first metatarsal in the treatment of hallux valgus. Foot Diseases 2(1):35-48, 1995

Besse, JL; Langlois, F; Berthonnaud, E; et al: Semi automated X-ray assessment of 50 hallux valgus cases treated by Scarf osteotomy, using the Piedlog software. Synopsis book, Second internat. AFCP spring meeting, Bordeaux May, 2000

Bonnel, F; Canovas, F; Poiree, G; et al: Evaluation of the Scarf osteotomy in hallux valgus related to distal metatarsal articular angle: a prospective study of 79 operated cases. Rev Chir Orthop Reparatrice Appar Mot. July 85 (4):381-6, 1999

Crosby, LA; Bozarth, GR: Fixation comparison for Chevron osteotomies. Foot & Ankle Int’l, 19(1):41-43, 1998

Kitaoka, HB; Alexander, IJ; et al: Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot & Ankle Int’l 15(7):349-53, 1994

Robinson AH, Limbers JP. Modern concepts in the treatment of hallux valgus. J Bone Joint Surg Br 2005. Aug;87(8):1038-1045 10.1302/0301-620X.87B8.16467 [PubMed] [CrossRef] [Google Scholar]

Weil LS. Scarf osteotomy for correction of hallux valgus. Historical prospective, surgical technique and results. Foot Ankle Int 2000;5:559-580 [PubMed] [Google Scholar]

Jones S, Al Hussainy HA, Ali F, Betts RP, Flowers MJ. Scarf osteotomy for hallux valgus. A prospective clinical and pedobarographic study. J Bone Joint Surg Br 2004. Aug;86(6):830-836 10.1302/0301-620X.86B6.15000 [PubMed] [CrossRef] [Google Scholar]

S.S.Suresh. Scarf osteotomy - Is it the procedure of choice in hallux valgus surgery? A preliminary report. Oman Med J. 2007;22(3):47-50.

Nix S, Smith M, Vicenzino B. Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. J Foot Ankle Res. 2010; 3:21. Published 2010 Sep 27. doi:10.1186/1757-1146-3-21

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.