Page 15 - Digi-Med_HBS-Snap-Off-Schrauben-2021-03-29

SURGICAL TECHNIQUE

SURGICAL TECHNIQUE

HAND AND FOOT SURGEY SCARF OSTEOTOMY

1. SURGICAL TECHNIQUE (SCARF OSTEOTOMY)

After lateral freeing of the base of the phalanx, a medial skin incision is
made over the first metatarsal.
- Exostosectomy is performed using and oscillating saw, taking care to
preserve cartilage integrity.
- Edges of the cut are smoothed off using a reamer or a small rasp.

2. OSTEOTOMY

- The longitudinal cut is performed on the medial aspect of the metatarsal
shaft, parallel to the plantar surface.
- Transverse bone cuts should be parallel to each other and
between 45o and 60o (depending on the technique used to
the longitudinal bone cut.)

3. TRANSLATION

After translation has been performed, it is maintained with the special
bone clamp
- Lateral translation is normally used. However, certain corrections
may require translation in the frontal or sagittal plane (for lowering or
shortening).

4. FIXATION

- A 10/10 Kirschner wire is inserted at the proper entry point and with
proper angulation (for head of shaft fixation), to serve as guide for later
drilling and screw insertion.
- Use the screw length gauge (using the substraction principle) to
determine the appropriate length of the screw. The lag screw should
be at least 4 mm shorter than the measured length to avoid cartilage
penetration.
- The cannulated drill is inserted over the guide wire and fully advanced to
create the countersink for the screw head.
- The selected screw is inserted and its head is carefully countersunk to
ensure optimal compression and avoid later impingement. Make sure that
the diaphyseal screw is firmly anchored in both cortices. The proximal
screw is inserted using the same Technique.

5. ANTEROMEDIAL RESECTION

- Once the screws are positioned, the anteromedial angle is cut
in line with the exostosectomy, using an oscillating saw. Edges of the cut
are smoothed off
- The capusule is closed in a routine fashion

Digimed Medizintechnik • Kreutzerstrasse 1 • 78573 Wurmlingen • Germany • www.digi-med.de 15