Scarf osteotomy-Horizontal capsulotomy
A horizontal capsulotomy (1) is performed in the midline for the scarf osteotomy .
The McDonalds retrtactor(2) is used to place the capsule under tension and ease its mobilisation . The proximal extent of the capsular release(3) should not extend far into the soft tissues attached at the plantar aspect of the metatarsal head in which important nutrient vessesls to the metatarsal run.