The Scarf osteotomy is one of the most commonly performed and reliable surgeries for correcting bunions (hallux valgus). It is named after the “Z-shaped” cut (like a scarf joint in carpentry) made in the first metatarsal bone of the foot.

When is it Recommended?

• Moderate to severe bunions with big toe drifting toward the second toe.
• Pain and deformity not relieved by non-surgical treatment (orthotics, splints, shoe modification).
• Patients wanting long-term correction and better foot alignment.

Surgical Technique

1. Incision:A small incision is made along the inside of the big toe joint.
2. Osteotomy:A Z-shaped cut is made in the first metatarsal bone.
3. Bone Shift:The lower part of the bone is shifted sideways to realign the big toe.
4. Fixation:Tiny screws are inserted to hold the bone in its new position.
5. Additional Steps (if needed):Soft tissue balancing or small bone procedures may be added for optimal alignment.

Advantages of the Scarf Procedure

• Powerful correctionfor moderate to severe bunions.
• Stable fixationwith screws – allows earlier movement.
• Preserves joint function(not a fusion).
• Durable, long-term resultswith low recurrence rates.
• Can be combined with other techniques (Akin osteotomy, soft tissue release).

Recovery

• Hospital stay:Usually day-care or overnight.
• Walking:Often allowed in a special post-operative shoe within a few days.
• Stitches removal:After 10–14 days.
• Return to normal shoes:6–8 weeks (depending on swelling and healing).
• Sports & full activity:Usually after 3–4 months.

Risks & Considerations

• Swelling (common for several months).
• Stiffness or limited movement of the big toe joint.
• Rare: recurrence, infection, delayed bone healing, or screw irritation.