Operative indications and cases to be wary of

The Scarf osteotomy is an ideal procedure to deal with all aspects of a bunionette deformity. It allows effective reduction of the laterally flared fifth metatarsal as well as easy concurrent correction of any articular surface component to the deformity. The relatively small dimensions of the fifth metatarsal does not often allow use of the Barouk screws. The DePuy twist off screws provide adequate hold and are more appropriately sized to this bone.