Scarf Osteotomy with Herbert Screw Fixation for Correction of Hallux Valgus in a Young Adult: A Case Report

Abstract

Background: Hallux valgus (HV) is a common forefoot deformity characterized by lateral deviation of the great toe and medial deviation of the first metatarsal. While adult HV differs mechanically from juvenile HV, both share instability of the first ray as a common pathway, and surgical correction must be individualized to the patient's specific deformity pattern.

Case Presentation: We report a 20-year-old woman who presented with painful bilateral forefoot deformity, RIGHT > LEFT , without antecedent trauma or systemic symptoms. Clinical and radiographic evaluation confirmed severe hallux valgus with an increased hallux valgus angle (HVA) and intermetatarsal angle (IMA) on the right foot. She underwent a Scarf osteotomy of the right first metatarsal with open reduction and internal fixation using two Herbert (headless compression) screws, combined with closed reduction and Kirschner-wire fixation of the right great toe. The postoperative course was uneventful; she was discharged on oral antibiotics, analgesics, and a structured physiotherapy and below knee slab application .

Conclusion: An individualized surgical strategy combining a diaphyseal first metatarsal osteotomy with herbert screw fixation and adjunct phalangeal correction can achieve satisfactory radiographic and early functional outcomes in symptomatic hallux valgus. This report adds to the limited case-level literature on combined Scarf–Herbert screw fixation and highlights points relevant to surgical decision-making and postoperative protocol design.