Scarf bunionectomy (Surgery Unit) Flashcards Preview

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Flashcards in Scarf bunionectomy (Surgery Unit) Deck (14):
1

 

Z-scarf or inverted Z is a A osteotomy

 

 

A: Mid-shaft osteotomy

 

2

 

What are the indications for Scarf osteotomy?

  1. IMA A
  2. B metatarsal 
  3. +/- deviated C
  4. D bone
  5. May be utilized in E

 

  1. A: 12 to 18 degrees
  2. B: average to wide metatarsal 
  3. C: PASA
  4. D: Solid non-osteopenic 
  5. E: May be utilized in a long or short 1st metatarsal 

3

 

What are the contraindications for scarf osteotomy?

  1. ? disease 
  2. Heavy ?
  3. Patient ?
  4. ?
  5. ? bone 
  6. IMA exceeding ? degrees 

 

 

  1. Metabolic bone disease 
  2. Heavy smoker
  3. Patient non-smoker 
  4. Obesity 
  5. Narrow, thin bone
  6. 18 degrees 

4

 

What are the variations to osteotomy cuts?

1. ? cut

2. ? of metatarsal neck 

3. start osteotomy in ?

 

 

 

1. Distal/proximal vertical cut 

2. dorsal/plantar 2/3rds of metatarsal neck 

3. distal metaphyseal bone 

5

 

Scarf modifications - inverted Z 

Provides 1?

 

 

1. greater resistance to disruption from weight bearing forces

6

 

What's another advantage of having the inverted Z-osteotomy, i.e. proximal cut existing dorsally?

 

 

 

Proximal cut exits dorsally-leaving proximal plantar surface intact to resist weightbearing

 

7

 

What's the purpose of axis guide?

 

 

Axis Guide-Utilized to perform osteotomy with greater precision

8

 

What's the displacement involved in osteotomy displacement?

Release of 2? allows for easy translocation

 

 

Metatarsal head displaced medially

2. lateral sesamoid

9

 

What's the main complication of osteosynthesis 1?

How to prevent it 2?

 

 

 

1. Troughing of bone with lateral displacement-results

2. should be performed in proximal 1/3rd of bone (cancellous bone)

 

10

 

What are the anti-troughing techniques?

1?

2?

3?

 

 

 

1. Distal bone graft

2. Distal screw into metatarsal head

3. Maintain non weight bearing-4-6 weeks

11

 

What is the post-op care?

 

 

                   Stable fixation-flat surgical shoe -3 weeks

Unstable fixation-CAM walker/crutches, scooter/

cast-6-8 weeks

12

 

What are the complications associated with Z-osteotomy?

1?

2?

3?

4?

5?

6?

7?

 1. Distal/proximal fractures

2. Troughing - dorsiflexion 1st met head

3. Too short Z - dorsiflexion 1st met head

 4. Central metatarsalgia

5. Non-union

 6. AVN

 7. Hallux varus

13

 

What is the complication for inverted Z osteotomy?

 

 

Similar to Z-osteotomy

 

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