[Treatments associated with scarf osteotomy for hallux valgus correction]. / Place des gestes associés à l'ostéotomie de Scarf dans le traitement de l'hallux valgus.

In view of the multiplicity of the proposed techniques for hallux valgus correction, we recommend to evaluate scarf osteotomy associated or not with phalangeal osteotomy and/or Weil osteotomy. We conducted a retrospective study of 29 patients, including a bilateral case, undergoing scarf osteotomy of the first ray with associated treatments in 80% of cases between 2011 and 2016. Results were analyzed on the basis of patients' satisfaction, Groulier index and radiological measurements. The overall Groulier score showed good objective assessment of the end results based on radiological and anatomical data influencing the end results in case of insufficient correction. The mean follow-up period was 3 years and 5 months. A significant reduction in phalangeal valgus (from 34.17% to 16.1%), in metatarsus varus (from 15.13% to 9.93%) and the distal metatarsal joint angle (17.63% to 12.73%) were obtained. Patients were satisfied and very satisfied in 83% of cases. Complications were dominated by hypocorrection in 13.3% of cases and no case of pseudarthrosis or of M1 head necrosis was reported. Our results are comparable to those reported in the literature. We particularly insist on the functional role of hallux valgus surgery that should be included in overall forefoot deformity correction. Scarf osteotomy requires rigorous technique. It gives reliable results, with limitations related to major deformities, especially of the distal metatarsal joint angle.

Dislocation of the First Metatarsophalangeal Joint: A Case Report and Suggested Classification System.

Dislocation of the first metatarsophalangeal joint is a relatively rare and still poorly known injury. The current classification includes only the dorsal variety of this lesion; thus, as further cases of other varieties are reported, a larger understanding of this entity is required. We report the case of a young male with dorsal dislocation of the first metatarsophalangeal joint treated by closed reduction. The clinical outcome at the 2-year follow-up point is reported. A review of the published data of the variations of this injury reported to date is included, and a new summarizing classification is suggested.