scarf osteotomy-radiographic preoperative
The particular features to look for ,which may influence whether the scarf osteotomy
is appropriate will be:
1)The presence of significant arthritis.
angle(18 to 2o degrees is the upper limit, higher angles will need Akin osteotomy
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 metatarsal
gia is present a shortening Weils osteotomy
of the second metatarsal
may also be needed.