Vuran The warmth of one s body will cause the staple to close faster. It is particularly useful in medium and major displacements. Extra-articular osteotomies of the forefoot Sizes include 1 mm diameter and 8 and 10 mm wide Stainless screww construction Dedicated instrumentation designed to ease implant insertion Straight and oblique designs 6. It has also been found that the best results concerning recesses with different profiles are obtained with a hexagonal profile of the wall  12batouk a distance e between two opposite faces 12 a of the hexagonal wall 12 of between about 1. In case of pes planus or for the fourth and fifth metatarsalsthe cut may be too long and the resection level should be lowered.
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Oman Med J. A preliminary report S. E-mail: moc. Copyright notice Abstract Many procedures are described in the literature for the surgical management of hallux valgus.
There are over surgical procedures described but the surgeon usually limits these to a few which he is comfortable with and which gives the best aesthetic and functional result to the patient. There is ever rising enthusiasm among orthopaedic surgeons regarding diaphyseal osteotomy ever since Burutaran described the procedure in Weil in United States and Barouk in Europe popularized the technique.
Scarf is a double chevron diaphyseal osteotomy which is inherently more stable than other osteotomies on the first metatarsal and allows early return to work. The author reports his early experience with SCARF osteotomy, which is a comparatively new technique for hallux valgus correction which was done in Ibri Regional Hospital in the Sultanate of Oman.
All patients who presented with symptomatic hallux valgus were taken up and there were three patients who required surgical intervention for hallux valgus. The purpose of this study was to find its effectiveness in terms of stability of the osteotomy and early return to work. Proximal phalangeal osteotomy was not found necessary in none of the three cases operated by us. Scarf osteotomy is safe and found to give better aesthetic and functional result and early return to work.
All our three patients had good functional recovery and early return to work. Keywords: Hallux Valgus, metatarsal osteotomy, Scarf osteotomy Introduction Numerous osteotomies have been described for the surgical correction of metatarsus primary varus component of the hallux valgus deformity. Over metatarsal osteotomies have been described in the world literature for the surgical management of hallux valgus. In clinical practice most of the surgeons limit these to a few procedures which invariably include soft tissue release, medial exostostomy combined with either proximal or distal osteotomy of the first metatarsal.
The outcome of surgical correction is sometimes unsatisfactory to the surgeon and undesirable for the patient. Any surgical procedure should result in a congruous first metatarso-phalangeal joint, painfree motion, improved cosmesis and ability to wear desirable footwear.
The procedure should also result in the least number of complications and should be easily reproducible. The first metatarsal scarf osteotomy has significantly improved the correction in hallux valgus and has recently gained popularity among European surgeons. Method Three cases of hallux valgus were operated by this technique from August till December The patients were operated for forefoot pain in one case, whose occupation is driver. One girl was operated for cosmetic concern.
And Shoe wearing problem was the presentation in a serving soldier. The patients were evaluated with radiographs, both weight bearing and non weight bearing films in antero posterior and lateral planes.
Intermetatarsal and hallux valgus angles were measured. A clinical photograph also was taken for pre operative record. All cases were operated and followed up by the author. Surgical Procedure All cases were done under epidural anaesthesia under tourniquet control.
Technique of First Metatarsal Osteotomy A median incision was done under tourniquet control from the midshaft level of the proximal phalanx distally to the base of the first metatarsal proximally. The plantar blood supply was taken care of during the procedure. The capsule and periosteal structures were elevated from the metatarsal head and neck. Divide the thin septum joining the abductor muscle to the medial border of the first metatarsal. Thus the first metatarsal medial border and its medial plantar surface were clearly visible.
Carefully preserve the dorsal synovial fold attached just proximal to the first metatarsal articular cartilage. The periosteal tissue about the first metatarsal shaft are incised in line with the proposed osteotomy and elevated plantarly and dorsally for few millimeters.
Screw according to claim i, having dimensions which lie in the following ranges: screw length: 10 mm to 60 mm head length 5 10 mm pitch of distal screw thread: between 1 and 3 mm pitch of proximal screw thread: between 0. Set of several screws according to claim 1, having at least different length dimensions. Set according to claim 4, wherein the set contains a number of screws of different lengths, but having the same characteristics in terms of diameter and therefore diametral size and self-boring and self-tapping ability. Screw according to claim 6 having dimensions which lie in the following ranges screw length 10 mm to 60 mm head length 5 10 mm pitch of distal screw thread between 1 and 3 mm pitch of proximal screw thread between 0. Set of several screws according to claim 6, having at least different length dimensions. Set according to claim 8, containing a number of screws of different lengths, but having the same characteristics in terms of diameter and therefore diametral size and self-boring and self- tapping ability.
Scarf osteotomy - Is it the procedure of choice in hallux valgus surgery? A preliminary report
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Foot Surgery Innovation in Forefoot Reconstruction - Biomet
Description The subject of the present invention is a self-tapping screw for small-bone surgery, particularly on the foot. The screw thread of the head has a smaller pitch than that of the distal part so as to make the screw self-compressing, that is to say screwing it in causes compression of the two bits of bone that are to be osteosynthesized by virtue of the difference between the pitches of the two screw threads. This screw also has a cannula and is self-tapping by virtue of notches made on the screw threads of the head and of the end of the distal shank. Finally, the diameter of the screw thread of the head is greater than the diameter of the screw thread of the distal part. This plain zone, which has a diameter identical to that of the distal screw thread, normally lies on each side of the osteotomy line and therefore allows the two bits of bone to be compressed one against the other without damaging the bony wall of the borehole, as the threaded distal part finishes entering the bone. This screw does, however, require the prior boring of a hole, with diameters similar to the root diameters of the distal and proximal threads, using a drill bit, the screw threads of the screw then performing their self-tapping function. The distal shank 3 is threaded over its entire length and is connected directly to the threaded head 2 by a short relief groove 2 b so that there is no plain intermediate portion between the head 2 and the distal shank 3.
US20030028193A1 - Self-tapping screw for small-bone surgery - Google Patents
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