Tailor’s bunion: results of a scarf osteotomy for the correction of an increased intermetatarsal IV/V angle

Abstract

Introduction: The aim of this study was to analyze clinical and radiological results of scarf osteotomy for the correction of an increased intermetatarsal IV/V angle in patients with symptomatic tailors bunion. Patients and methods: Between 1997 and 1998, we performed a scarf osteotomy for the correction of an increased intermetatarsal IV/V angle (IMA) in ten cases. The indication was a painful prominence of the fifth metatatarsal with an increased IMA. Fixation of the osteotomy was performed with two 1.7-mm titanium miniscrews. Mobilization was allowed with full weight-bearing, with a forefoot relief orthosis. Clinical results were evaluated with the forefoot scoring system (ffss). The determination of the IMA was performed with weight-bearing dorsoplantar radiographs. Results: All osteotomies healed within the first 6 postoperative weeks. Removal of the screws was not necessary in any case. The mean preoperative ffss was 29.5 points. At the last follow-up, the mean value of the ffss was 73 points and no patient presented a painful prominence above the fifth metatarsal head. The mean IMA was reduced significantly from 10.3 to 6.8°. Discussion: The scarf osteotomy is an adequate surgical procedure for the correction of an increased IMA in patients with symptomatic tailor’s bunion.