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Categories: Abstracts, 2017, Podium

Increased recurrence in Scarf osteotomy for mild & moderate hallux valgus with Meary's line disruption

O. Bagshaw, R. Faroug, L. Conway, J. Ballester

1NHS, Whiston, United Kingdom

2Royal Liverpool Hospital, Orthopaedics, liverpool, United Kingdom

3Royal Liverpool Hospital, Liverpool, United Kingdom

4Whiston Hospital, Whiston, United Kingdom 

Introduction: This paper tests the null hypothesis that there is no difference in recurrence for mild and moderate hallux valgus treated with Scarf osteotomy in the presence of a disrupted Meary's line compared to an intact line.

Methods: At a minimum of 3 months follow up we retrospectively analysed radiographs, theatre and clinic notes of 74 consecutive patients treated with Scarf osteotomy for mild and moderate hallux valgus at a single centre. The patients were divided into Group A (n=30) - patients who on pre-operative weight bearing radiographs had a disrupted Meary's line, and Group B (n=44) - those with a normal Meary's line on pre-operative weight bearing radiographs.

Results: Our results demonstrate a statistically significant higher recurrence in group A compared to Group B with an odds ratio of 5.2 p = 0.006 [95% CI 1.6-17]. The association between a disrupted Meary's line and increased risk of recurrence for Scarf osteotomy remains valid and strengthened to an odds ratio of 7.1 p = 0.015 [95% CI 1.46 -34.4] when adjusted for confounding variables of age, sex and pre-operative IMA. On this basis we reject the Null hypothesis. In group A two out of 30 patients required revision surgery whilst none of the 44 patients in group B needed revision. In Group A the degree of IMA correction achieved equalled 8.1 degrees with a pre and post IMA of 16.0 and 7.9 degrees respectively. For Group B the degree of correction was 8.0 degrees with a pre and post IMA of 14.3 and 6.3 degrees respectively. Eight complications were reported in Group A and 9 in Group B.

Conclusions: Our results demonstrate a statistically significant increased risk of recurrence when scarf osteotomy is performed for mild and moderate hallux valgus in the presence of a disrupted Meary's line.

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