A Patient That Came in for Bunion Surgery: The Scarf Osteotomy Approach, including before and after pictures of bunion surgery.

Sheila's Story: Seeking Relief from Bunion Pain

In the bustling heart of New York City, Sheila faced a challenge that affects millions: a painful bunion. This condition, more than just a cosmetic issue, impacted her daily life and comfort. Determined to find a lasting solution, Sheila turned to the renowned podiatry experts at Citi Footcare, a practice celebrated for its innovative approach to foot care.

Understanding Bunions: More Than Just a Foot Deformity

Bunions, medically known as hallux valgus, occur when the first metatarsal bone of the foot turns outward (first metatarsal varus) while the big toe points inward towards the other toes. This misalignment results in a prominent bony bump on the side of the foot and can lead to significant pain and discomfort. Over time, the condition can worsen, leading to chronic pain and mobility issues.

Preoperative Photo:

Here you can clearly see the bunion deformity where the first metatarsal bone has moved medially to stick out on the inside of the patient’s foot.

Scarf bubionectomy in NYC

First Metatarsal Varus and Hallux Valgus: A Closer Look

The condition starts with the first metatarsal bone moving in a varus position, causing the toe to angle in a valgus position. This movement not only affects the joint at the base of the big toe but can also lead to secondary issues such as corns, calluses, and hammertoes. Understanding this underlying pathology is crucial in determining the most effective treatment approach.

Choosing the Scarf Osteotomy for Bunion Correction

After careful evaluation at Citi Footcare, the decision was made to proceed with a scarf osteotomy for Sheila. This decision was based on the nature of her bunion deformity and her overall foot structure. At Citi Footcare, we often use the scarf osteotomy, despite being technically more difficult and other osteotomies, in order to address the deformity more proximal at its origin. The scarf osteotomy is far superior to more distal osteotomies that are commonly performed by most foot surgeons.

The Scarf Osteotomy Procedure: A Detailed Walkthrough

The scarf osteotomy is our preferred surgical method for bunion correction due to its effectiveness and stability. This procedure involves a series of intricate steps:

  1. Incision and Exposure: A precise incision is made along the side of the foot to expose the metatarsal bone.
  2. Bone Cutting: The metatarsal bone is cut in a Z-shape (scarf cut), allowing for multiplanar correction of the deformity.
  3. Bone Realignment: The segments of the bone are shifted to realign the toe and correct the varus position of the metatarsal.
  4. Fixation: Two screws are strategically placed to secure the bone in its new position, ensuring stability and promoting proper healing.
  5. Closure: The incision is meticulously closed with a plastic surgery type method, and a dressing is applied to protect the surgical site.

Postoperative Photo 1:

Here you can clearly see the bunion deformity is gone. This photo was taken to months after surgery. You can see there is still swelling noted to the entire forefoot. Note that there is a relatively straight line the tip of first toe back to the midfoot. This is in contrast to the preoperative photo where a large bump is present.

Postoperative bunion surgery at 8 weeks

Postoperative Photo 2:

On this side view photo, note the well-healed incision despite being only 8 weeks after surgery. This is achieved warming a plastic surgery type suture technique. You can also see at the distal end of the incision there is a vertical component that is about 90° to the main part of the incision. Here, a skin plasty was performed to remove a triangle-shaped area of skin in order to remove excess skin that was present due to the bunion deformity.

Postop Scarf Side View

Post-Surgical Recovery: Journey Toward Mobility

Sheila's recovery was carefully monitored by the experts at Citi Footcare. The post-surgical phase is critical and involves several stages:

  1. Immediate Post-Op: Initial days focus on rest, ice, compression, and elevation to reduce swelling and pain. Patients are requested to stay off their feet the first 3 days. They will wear a surgical boot for around 4 weeks.
  2. Rehabilitation: Gradual off-weight-bearing exercises, followed by weight during exercise are introduced to aid in recovery.
  3. Follow-Up Care: Regular check-ups ensure proper healing and alignment of the toe. We continue to see our patient periodically for up to one year surgery.

Expected Recovery Times and Activity Restrictions

Typically, patients can expect to return to normal activities within 6 to 8 weeks post-surgery. However, full recovery, including the resumption of high-impact activities, may take up to 3-6 months. During this period, patients are advised to wear comfortable footwear and avoid strenuous activities to facilitate healing.

Long-Term Success: Relief from Bunion Pain

The long-term outcomes of a scarf osteotomy are highly favorable. Patients like Sheila experience significant relief from bunion pain and improved foot function. This procedure not only corrects the physical deformity but also enhances the quality of life by allowing a return to normal activities without discomfort.

Why Citi Footcare is the Best Choice in New York City

Citi Footcare, led by Dr. Emanuel Sergi and a team of skilled podiatrists and podiatric surgeons, is renowned for its expertise in treating foot conditions like bunions. The clinic's state-of-the-art facilities, coupled with a patient-centric approach, make it the preferred choice for individuals seeking high-quality podiatric care. With a track record of successful outcomes and personalized treatment plans, Citi Footcare stands out as the leading podiatry practice in New York City.

Seeking Podiatry Treatment and Bunoin Surgery at Citi Footcare

For those suffering from foot conditions like bunions, Citi Footcare offers comprehensive treatment solutions. Under the guidance of Dr. Emanuel Sergi and his team, patients receive the highest standard of care. Reach out to Citi Footcare today to embark on a journey toward pain-free feet and improved mobility.

Citi Footcare
122 East 42nd Street
Suite 2901
(E 42nd and Lexington Ave)
New York, NY 10168



Leave a Comment