scarf osteotomy-radiographic preoperative
assessment.
The particular features to look for ,which may influence whether the scarf osteotomy is appropriate will be:
1)The presence of significant arthritis.
2)The intermetatarsal angle(18 to 2o degrees is the upper limit, higher angles will need Akin osteotomy as well).
3)The distal metatarsal articular angle(if significantly into valgus the scarf is a good way of correcting this)
4)The amount (in cm) by which the seasamoid is uncovered(a reasonable guide ,allowing for magnification, by how much to translate the osteotomy)
5)The presence of a laterally oblique joint at the IP joint(hallux interphalangeus). This may require correction using a Akin osteotomy.
6)The relative length of the second compared to first metatarsal. If transfer metatarsalgia is present a shortening Weils osteotomy of the second metatarsal may also be needed.