Aim of the study: Treatment of bunionette deformity with plantar ulcers is not well elaborated in the literature at present. Scarf osteotomy, as the most preferred mode of treatment in cases of bunionette deformity without ulcers, has been described. Our study is to analyze the efficacy of scarf osteotomy in treating bunionette deformity with different grades of plantar ulcers.
Materials and methods: Twenty patients with bunionette deformities with plantar ulcers (male—9, female—11) were included in the study. We retrospectively analyzed the functional score foot function index (FFI), clinical-healing time of the ulcers, and radiographic parameters—fourth/fifth intermetatarsal and lateral deviation angles (LDAs). Complications (three patients) were also reviewed during the follow-up. The patients were operated on between 2021 and 2023, with the most extended follow-up of 24 months.
Results: The average FFI score improved from 49.22 to 10.7, the 4–5 intermetatarsal angle (IMA) decreased from 11.2 ± 3.14 preoperatively to 4.97 ± 1.09, and the LDA decreased from 6.7 ± 3.42 preoperatively to 3.21 ± 0.42 at final follow-up, respectively. The average ulcer healing time recorded in this study was 44.5 days, and the average osteotomy healing duration was 90 days. The complications noted were infections, ulcer recurrence, and implant removal.
Conclusion: The scarf osteotomy can be an acceptable treatment modality for bunionette deformity with plantar ulcers, offering good results at midterm follow-up.
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