Possibilities of Scarf osteotomy in surgical correction of hallux valgus

Hallux valgus refers to a complex progressive deformity of the foot, caused by an imbalance of static and dynamic constraints leading to the deviation of the head of metatarsal bone in axial, coronal, and sagittal planes. The efficacy of surgical treatment for this deformity ranges from 80 % to 95 %, while 15 % to 40 % of patients report dissatisfaction with the outcomes of foot deformity surgeries. Scarf osteotomy is considered the optimal method for correcting hallux valgus deformity, involving a Z-shaped cut in the area of the first metatarsal bone, which reduces the intermetatarsal angle. The advantages of scarf osteotomy include providing stability and rigid compression at the osteotomy site, allowing for early weight-bearing and bilateralization. Scarf osteotomy prevents shortening of the first ray and facilitates early mobilization of the patient. It can be performed for varyious degrees of foot deformity, from mild to severe. The most common complications associated with surgical treatment of hallux valgus include persistent pain syndrome, recurrence of deformity, hallux varus, secondary fragment displacement, avascular necrosis of the first metatarsal head, nonunion, and infection.