Abstract
Osteomyelitis of the first metatarsal after scarf osteotomy is a rare complication. This case report describes a 60 year old patient after scarf osteotomy of the first metatarsal as a part of a complex forefoot deformity surgery.
The postoperative progress was without complications until removal of stitches. Subsequently the wound become infected, and osteomyelitis of the first metatarsal gradually developed.
The response to this complication involved repeated revisions, removal of metals, debridement, removal of necrotic tissue and both local and systemic application of antibiotics. With the outcome being unsatisfactory, the patient was sent for further treatment to higher status instutution, where he underwent further surgeries with application bone cement with antibiotics and subsequent spongioplasty.
Two years after the primary surgery, the patient is without signs of infection and, according to X-ray examinations, with a healed but deformed metatarsal, but he is not satisfied with the result. He suffers from mild pain while walking.
Osteomyelitis arising as a complication of forefoot surgery is a rare but it needs to be kept in mind when superficial infections relapse. Its subsequent treatment is very difficult and lengthy.
Radical approach with removal of metallic material, debridement and application of local antibiotic carriers is fundamental. It is appropriate to consult a higher status institution.