1. Mohammed Elnaggar Jason Eyre Simon Sturdee
Scarf osteotomy for Hallux Valgus correction – an audit of patient satisfaction
Mohammed Elnaggar
Jason Eyre
Simon Sturdee

2. Why satisfaction audit?
Ever more common procedure for Hallux Valgus correction (particularly amongst F&A community)
Patients frequently ask success rates in clinic before committing to surgery
To examine the role of Akin osteotomy
To audit outcomes of Senior surgeons practice

3. Method
Junior author identified all patients undergoing Scarf osteotomy in NHS (CRH) April 2008-Mar 2010
Patients contacted via telephone numbers registered in PAS system
Asked a simple questionnaire of 4 questions (see next slide)
Results recorded using Microsoft Excel

4. Sample Questionnaire Q1. degree of satisfaction Q2.if the other foot
How satisfied are you with the surgery you have had for your bunion? (Very satisfied- satisfied-neutral- unsatisfied – very unsatisfied)
Q2.if the other foot
If you had the same problem with a painful bunion on the other foot would you have the same surgery on that foot ?
Q3.if a friend or a relative
Would you recommend the surgery to a friend who had a similar problem with a bunion?
Q4.complications
Have you had any complication from this surgery?

5. Patient demographics April 2008-Mar 2010
Total patients identified = 64
83 scarfs in 64 patients ( 19 bilateral)
Total patients contactable = 42
53 scarfs in 42 patients (11 bilateral)
Age range 17 – 89years ( mean age = 52 )
F: M = 54:10 = 5.4 : 1
Number of Akin + Scarf = 30 (36%)

6. Results

7. Q1 degree of satisfaction

8. Q2: repeating surgery

9. Q 3: recommending the surgery

10. Results: Q4 Complications
Infection
3 (superficial)
All resolved at 2 weeks with oral antibiotics
No Chronic regional pain syndrome

11. Discussion
>83% patients are satisfied with surgery at CRH in this single surgeon series
Only 2 patients were unsatisfied(4.7%)
88 % would recommend this procedure to a friend or undergo it again
>95% were either very satisfied, satisfied or neutral

12. Reproducible operation
Powerful 3D correction in right hands
Minimal complications consistent with other forms of corrective osteotomy

13. Summary
Scarf procedure is successful , safe and reproducible correction of Hallux Valgus
>83% of CRH / HRI patients satisfied with this surgery in this single surgeon series
It can take 9-12 months for patients to fully recover from forefoot surgery, particularly swelling

14. Questions?

15. Thank you
With thanks to PAS office, SWS secretary , audit department and enquiry desk for their help in collecting and presenting this data