A scarf osteotomy (sometimes performed with an Akin osteotomy) is surgery for bunion removal or the correction of a deformity at the base of the big toe, and the realignment of the toe itself.
During the procedure parts of bone are removed and the bones of the foot and toe are realigned correctly. Any bunions, or bumps on the joint, will be removed at the same time. The procedure will help correct the deformity, alleviate the pain associated with the condition and reduce the pressure caused by the big toe jamming against the other toes.
The operation may be carried out under a general anaesthetic (so you’ll be asleep) or a local anaesthetic (so you’ll stay awake but won’t feel anything). The operation usually takes around an hour and you’ll usually go home on the same day.
There are a number of different types of operation used to treat bunions; the type of surgery you undergo will be discussed with your specialist beforehand. It will depend on the exact condition you have, its severity, the shape of your foot and whether you have any wear and tear (osteoarthritis) in the joint.
One common procedure is called a scarf osteotomy (an osteotomy means a cut in the bone) where the bone is cut and rejoined to improve the alignment of the toe. The operation is carried out through one cut on the foot, to the side of the big toe. A tendon is adjusted to bring the toe into the correct position before the bone is cut and realigned. The bone is then fixed with screws and the joint is repaired to keep the toe straight.
In some severe cases, an additional procedure called an Akin osteotomy may be needed to achieve good correction and alignment.
Immediately after surgery we’ll help you manage any pain or discomfort with painkillers. We’ll discuss your aftercare and arrange any follow-up appointments with you before you leave hospital.
In the next few days you’ll be able to walk with the aid of crutches but you’ll need plenty of rest with your foot raised. You will be given a special shoe to make sure you don’t put too much weight on the wrong part of your foot.
After three to four weeks you may be able to return to work and resume normal day to day activities. After eight to twelve weeks your foot should start to feel normal again and it may be possible to return to sport. After six months there should only be slight swelling (if any) and you should be feeling the full benefits of surgery.
As with any surgical procedure there can be some risks, including:
- blood clots (including deep vein thrombosis (DVT))
Specific risks of bunion surgery include:
- nerve damage, numbness
- bone not healing well
- inability to move big toe
- pain in other parts of the foot (particularly the ball or other toes)
- recurrence of bunions
- complex regional pain syndrome (can cause chronic burning pain in one of the limbs)