Background: Postoperative hallux varus is often accompanied by an abnormal decrease in the first-second (M1M2) intermetatarsal angle, which we have sought to correct by a reverse scarf-type osteotomy. Methods: A series of 36 hallux varus operated on by reverse scarf osteotomy, including 14 with prior osteotomies, was reviewed with an average follow-up of 56 months. The measurements were clinical: American Orthopaedic Foot & Ankle Society (AOFAS) score, visual analog scale (VAS) pain score, subjective satisfaction index, joint mobility, and radiologic angles: M1M2 and first metatarsophalangeal angle. Results: The M1M2 angle increased on average from 3 to 8 degrees whereas the average M1P1 angle of varus went from −21 to +9 degrees, including 2 patients who had a reoccurring valgus of 20 degrees. The median AOFAS score increased from 47 to 79, the VAS from 6.7 to 2.3, joint mobility lost an average of 9 degrees, and all those operated on were satisfied with the result. All operated bones healed without secondary displacement. Discussion: The reverse scarf osteotomy is capable of correcting the intermetatarsal angle and at the same time correcting the postoperative hallux varus. Functional scores generally improved, including in patients with a reoccurring valgus and those with reduced mobility. Conclusion: The reverse scarf osteotomy can be performed to treat postoperative hallux varus with a mild intermetatarsal angle with reasonable clinical and radiologic results. Level of Evidence: Level III, retrospective cohort study.

The possibility of serious wound complications and of recurrence must be kept in mind when operating on a limb deformity in patients with Proteus syndrome. Potential complications should be taken into account in selecting the surgical correction technique: epiphysiodesis may be preferable to osteotomy.

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Background:The Latarjet procedure may be amenable to outpatient elective surgery as it is often performed on young and healthy patients. Thus, ambulatory surgery for Latarjet procedure is recently rapidly increasing in France with very few validation studies. This feasibility study presents early adverse events following outpatient Latarjet surgery compared to Latarjet surgery performed as an inpatient procedure. Hypothesis:There is no difference between outpatient or inpatient Latarjet procedure.Patients and Methods: Thirty patients operated on an outpatient basis and prospectively followed were compared to 30 patients operated on an inpatient basis. All procedures were performed by the same surgeon. Complication rates as well as clinical outcomes at one year were compared between groups.Results: Post-operative hematomas which did not require surgery occurred more frequently in outpatient group in which no drain was used. No other differences occurred between groups. All outpatients but one was satisfied with the procedure. Discusion:The latarjet procedure was found to be safe when performed on an outpatient basis. The addition of wax to the base of the coracoid seemed to diminish hematoma formation.

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