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Modified Scarf procedure with Akin osteotomy to treat moderately severe hallux valgus

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Objective To observe the clinical effects of modified Scarf procedure combined with Akin osteotomy to treat moderately severe hallux valgus. Methods From June 2009 to December 2015, 60 patients with moderately severe hallux valgus were reviewed, who were treated by the modified Scarf procedure.that is on the basis of Scarf procedure, after changing the direction of distal bone cutting line, adding the second osteotomy at the distal fragment of the metatarsal head by excising a cuneiform fragment, then rotate the distal fragment until dorsolateral edge of the proximal fragment and the bone defect is well matched, combined with Akin osteotomies, and were observed therapeutic effect by AOFAS and X-ray examination.Results All cases were followed up for 8 to 38 months (mean 21.6 months).All operative incision healed primarily, with no delayed union or nonunion.After surgery, HVA（11.9±0.1）°,IMA（7.5±1.4）° were significantly decreased compared with those before operation （18.2±2.3）°,（3.4±1.3）°P<0.05. AOFAS score （87.5±7.4 ）was significantly higher after surgery than that before surgery（37.5±8.4 ）,P<0.05. Conclusion Modified Scarf combined Akin osteotomies can achieve a excellent therapeutic effect for moderate and severe hallux valgus with very few complications and recurrence, which is worth for clinical application