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Scarf Osteotomy: What Is It?

The document describes a scarf osteotomy procedure to correct a severe bunion deformity. It involves cutting and repositioning the bones and tightening soft tissues to correct the deformity. Recovery typically involves some pain, stiffness, and swelling. Complications can include ongoing pain, recurrence of the deformity, infections, or nerve damage.

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Mohammed Alfahal
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23 views3 pages

Scarf Osteotomy: What Is It?

The document describes a scarf osteotomy procedure to correct a severe bunion deformity. It involves cutting and repositioning the bones and tightening soft tissues to correct the deformity. Recovery typically involves some pain, stiffness, and swelling. Complications can include ongoing pain, recurrence of the deformity, infections, or nerve damage.

Uploaded by

Mohammed Alfahal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Scarf Osteotomy

What is it?
Scarf osteotomy is an operation to correct a severe bunion (hallux valgus) deformity.

Why would it be done?


Surgery for a bunion may be advised if simple measures, such as well-fitting shoes, simple
painkillers and padding do not relieve the discomfort of the bunion. It is only appropriate if you
are willing to be realistic about shoe-wear after surgery, and understand and accept the
potential problems of the procedure.

What does it involve?


A cut is made between the big and second toes. Through this cut the tight tissues on this side of
the big toe are freed.

Then a cut is made over the bunion. The big toe joint is opened and the bony lump is removed.
The knuckle bone (first metatarsal) is cut through, re-positioned and fixed with two small
screws. The soft tissues of the big toe joint are tightened on the inside to correct the deformity
and the wounds stitched up, usually with stitches that dissolve inside your skin.

Can it be done as a day case operation?


If you are medically fit, have someone who can collect you and look after you after the
operation, and you are comfortable afterwards, the operation can be done on a day case basis.

However, if you have other medical problems such as diabetes, asthma or high blood pressure,
you may have to stay overnight after surgery.

The commonest reason for having to stay overnight after bunion surgery is for pain control, as
these operations involve a lot of reconstruction work on the joint and ligaments of the toe. They
may therefore be quite painful immediately afterward.

Will I have to go to sleep (general anaesthetic)?


The operation is usually done under general anaesthetic (asleep). In addition, local anaesthetic
may be injected into your ankle while you are asleep to reduce the pain after the operation even
if you go to sleep for the surgery. You will also be given pain-killing tablets as required.

Discussion with your anaesthetist on the morning of your surgery will confirm this.

Will I have a plaster on afterwards?


You don't usually need a plaster after a scarf osteotomy. Usually we will put dressings and a
bandage on your foot and you can walk on it in a protective sandal with a stiff sole. Your
surgeon will discuss this with you.

How soon can I?…


Walk on the foot?
You will be able to walk on the foot almost immediately. You will have to walk with a flat foot for
six weeks.
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Go back to work?
This depends on what you do and how you get to work. If you have a sitting-down job that you
could do with your foot in bandages and you can get to work, you could probably go back to
work two weeks after surgery. On the other hand, if you have a heavy manual job you may be
off for up to three months. If you need to drive to work then you will be off for six weeks. Your
surgeon will advise you about going back to work.

Drive?
Once your bandages have been removed you may be able to start driving again. You must be
comfortable and not too stiff before trying to drive. Start by sitting in the car and trying the
pedals then drive round the block. Drive short distances before long ones. Remember, if you
cannot safely make an emergency stop your insurance will not cover you in the event of an
accident. Ask your surgeon when it is safe for you to drive again.

Play sport?
After removal of the dressings you can start gently exercising your foot and walking further each
day. When you are comfortable doing this you can start gentle running and stretching at
approximately three weeks. Contact, twisting and impact sports can follow as comfort dictates.
Everyone is different in how quickly they can take up exercise again: be guided by your own
body's reactions and the advice of your surgeon. Most people can get back to most of their
previous activities within six months of bunion surgery.

What can go wrong?


Research shows that 85% of people who have bunion corrections are satisfied with the
results.

However, a number of problems can arise.

1. Stiffness
The big toe is usually stiffer than before. For most people this does not matter, but for
athletes or dancers it is very important.
2. Pain
The big toe is slightly weaker with a bunion, and this transfers weight onto the ball of the
foot. After bunion surgery this transfer of weight can increase. Therefore, if you have pain
under the ball of the foot ("metatarsalgia") it may be worse after bunion surgery and it may
also develop for the first time.
Most people who develop metatarsalgia are comfortable with a simple insole in the shoe
but occasionally surgery is required.
3. Recurrence
In some people the big toe slowly tilts back toward the original position and occasionally
this is bad enough to need to have the operation redone. Because a scarf osteotomy is
done for severe deformities in which the tissues are fairly tight, this risk is slightly higher
than for other bunion operations.
4. Infections
Infections in the wound and minor damage to the nerves of the toe can occur in any foot
surgery. Usually these are minor problems that get better quickly.

5. Swelling
The foot tends to swell up quite a lot after surgery. Swelling is part of your body's natural
response to any injury and surgery is no exception. In addition, your foot is at the bottom of
your body so fluid tends to collect in its tissues ("at the bottom of the slope") and cause
swelling. People vary in how quickly this swelling disappears after an operation and six
Page 2 of 3
months is not all that unusual. Provided you are not having undue pain or inflammation
there is probably nothing to worry about and you can afford to give it time.

Important information
The information in this leaflet is for guidance purposes only and is not provided to replace
professional clinical advice from a qualified practitioner.

It is important to prepare for an operation to reduce the risks of complications. There is


information about how to do this at: https://www.cpoc.org.uk/patients.

Your comments
We are always interested to hear your views about our leaflets. If you have any comments,
please contact the Patient Experience Team – Tel: 0300 131 4731 or by email at: esh-
[email protected]

Hand hygiene
The Trust is committed to maintaining a clean, safe environment. Hand hygiene is very
important in controlling infection. Alcohol gel is widely available at the patient bedside for staff
use and at the entrance of each clinical area for visitors to clean their hands before and after
entering.

Other formats
If you require any of the Trust leaflets in alternative formats, such as large
print or alternative languages, please contact the Equality and Human
Rights Department.

Tel: 0300 131 4500 Email: [email protected]

After reading this information are there any questions you would like to ask? Please list below
and ask your nurse, doctor or practitioner.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Reference
The directorate group that have agreed this patient information leaflet: Orthopaedics

Next review date: February 2024


Responsible clinician: Mr A Skyrme, Consultant Orthopaedic Surgeon

© East Sussex Healthcare NHS Trust – www.esht.nhs.uk

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