Bunion Correction with Scarf and Akin Osteotomy

Overview

This procedure is used to correct a bunion, a deformity of the joint at the base of the big toe. During this procedure, portions of bone are removed and the bones of the foot and toe are aligned properly, eliminating the bump on the inner side of the foot.

Preparation

After anesthesia is administered and foot is cleaned and sterilized, the surgeon makes a short incision between the first and second toes and carefully releases the tight ligaments that are holding the toe out of alignment.

Accessing the Joint

The surgeon creates a longer incision on the side of the toe to expose the first metatarsal and the proximal phalanx. The joint where these bones meet is called the metatarsophalangeal (MTP) joint.

Realigning the Metatarsal

Using a saw, the surgeon removes the bump of bone that forms the bunion. The surgeon then makes a series of cuts in the metatarsal, dividing the bone into two pieces. The surgeon manipulates the angle of these pieces so that it is positioned closer to the second toe. Screws are placed to anchor the bone pieces. A sliver of bone that has become offset by the realignment is trimmed.

Straightening the Toe (Akin Osteotomy)

In some cases which require further realignment, the surgeon removes a wedge of bone from the phalanx, allowing the toe to be straightened. A staple or screw is used to anchor the bone.

End of Procedure

The incision is closed, and the foot is bandaged. The foot will be placed in a special shoe that will allow weight bearing only at the heel. Normal activities can usually be resumed within six to eight weeks.

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