‘Reverse’ scarf osteotomy for bunionette correction: Initial results of a new surgical technique

BackgroundThe bunionette or tailor's bunion is a lateral prominence of the fifth metatarsal head. It is usually characterised by a wide intermetatarsal angle (IMA) between the 4th and 5th metatarsals, varus of the metatarsophalangeal (MTP) joint, pain and callus formation. Various distal, shaft and basal osteotomies have been described in the literature. We have described a reverse scarf osteotomy for bunionette correction.Patients and methodsWe have used a ‘reverse’ scarf osteotomy in 12 cases (10F: 2M) with a mean follow-up of 12 months (range 5–22 months) with radiographs and clinical scoring.ResultsPost operatively, mean IMA improved from 13.1° to 7.27° (range 2.0–11.5°); mean 5th MTP angle improved from 19.9° to 6.36° (range 2.8–9.0°) and postoperative mean AOFAS improved from 54.25 to 89.58 (range 70–100).Conclusion‘Reverse’ scarf osteotomy in the correction of bunionette deformity offers promising results in the short term.