Scarf osteotomy-proximal extent of dissection
Once the superficial layer containing the DMCN has been identified distally the dissection is continued proximally (1) avoiding the line of the nerve and taking a full thickness flap .
The proximal extent of the dissection(3)for scarf osteotomy is marked by the plantar
metaphyseal flare at the metatarsal base. There is often a vein transversely at this level(2) to be avoided. The Wests retractor is used here.