Bunion Correction with Scarf and Akin Osteotomy

What are bunions?

Bunion IllustrationBony bumps that form on the joint at the base of the big toe, bunions occur from bones shifting out of place. When bones of the big toe shift out of place, the toe moves diagonally. The tip of the big toe moves towards the outer foot, shifting the base out of place towards the medial aspect of the foot. Bunions form due to the shape of an individuals foot, medical conditions, and wearing ill-fitting shoes.

Foot and ankle physicians can typically diagnose bunions easily. Symptoms of bunions often include:

  • Lack of range of motion of the big toe
  • Pain at the base of the big toe
  • Swelling around the base of the big toe
  • A bump at the base of the big toe that bulges out

Treatment of bunions

Multiple treatment methods for bunions exist. This article focuses on bunion corrections with scarf and akin osteotomy. During a bunion correction with scarf and  akin osteotomy, a foot and ankle orthopedic physician removes portions of the bone and realigns the bones of the foot and toe. With the bones properly aligned, the bump no longer exists.

bunion correction with scarf and akin osteotomy procedure

When performing a bunion correction with scarf and akin osteotomy, an anesthesiologist places the patient under general anesthesia. When under general anesthesia, the patient remains asleep for the entirety of the procedure. The nurse or surgeon thoroughly cleans the surgical area with an antibacterial solution.

After properly prepping the patient, the surgeon starts the procedure. The surgeon first creates a small incision between the big toe and the second toe. The surgeon uses this incision to access the tight ligaments and releases them. The surgeon must release the tight ligaments due to the ligaments holding the toe out of alignment.

Next, the surgeon creates an additional and longer incision. The surgeon creates this second incision on the side of the big toe, exposing the metatarsophalangeal joint. The surgeon then uses a type of bone saw and removes the bump of bone. After removing the bump of bone, or bunion, the surgeon makes two additional cuts into the metatarsal and cuts it into two pieces. Using screws to secure the pieces of bone into place, the surgeon repositions the angle of the two bones to position them closer to the second toe. If the surgeon finds a piece of offset bone present, the surgeon trims it.

Some bunion corrections need further realignment of the bones. When needed, a surgeon performs an akin osteotomy. During an akin osteotomy, the foot and ankle surgeon removes a piece of bone from the phalanx in order to straighten the toe. The surgeon holds the bone into place using a screw or other medical device. Some cases may require a Lapidus Arthrodesis to fuse portions of the midfoot. This concludes the bunion correction with scarf and akin osteotomy procedure.

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