Bunion Treatment: Scarf / Akin Osteotomy

Patient Information Sheet - Bunion Treatment: Skarf/Akin Osteotomy

Bunions are a common deformity in our community. They occur due to a muscle imbalance that is either inherited or caused by inappropriate footwear. Bunions worsen as we get older and can eventually cause pain and deformity. The bunion may damage other parts of your feet as well. Pain is felt because of their size and abnormal mechanics. The time to have treatment is when they cause significant pain or you have difficulty in finding comfortable footwear. Occasionally bunions are treated when they are not painful in themselves but are placing the rest of the foot at risk of major problems.

At The Park Clinic we use a treatment known as the Scarf/Akin Osteotomy. This is one of the most advanced treatments available. This practice was one of the first in the country to use this treatment which in our opinion has revolutionised the management of this problem. We have used this treatment exclusively for the last 5 years and now have performed around 900 procedures.

If you know someone that has had bunion surgery but not at this practice they may not have had the same treatment as we are recommending. This treatment is only available at a small number of centres. Please understand that many operations for bunions have been tried over the years with varying levels of success.

Most have failed due to high recurrence rates, excessive joint stiffness or by transferring problems to other parts of the foot. The reason why we use the Scarf/Akin Osteotomy is it solves many of these problems.

The procedure has been popularised by Mr. Louis Barouk, a French foot specialist and this procedure is the most common bunion operation performed in that country. The keys to its success are that it is restores foot mechanics, allows excellent joint motion and has very low recurrence rates.

The Scarf / Akin Osteotomy Procedure

Scarf osteotomy

Post Operative

Immediate weight bearing is possible and plaster is not required. Once the bandages are removed in 14 days and the wound healed you are free to move about as you wish. As with all foot surgery, swelling occurs and this is the main limitation to activity and footwear in the early phases. Swelling increases over a 6 week period and then reduces over a further 6 weeks. As such your final result begins 3 months after surgery. As the mechanics in your foot have been substantially changed, your body will go on making subtle adjustments over a 12 month period.

Before Surgery

After Surgery

Perhaps just as significant as the procedure advancements is the improvements we have made in post operative pain relief. Foot surgery without appropriate pain relief is extremely uncomfortable. This practice was the first in Victoria to extensively use a sciatic nerve block for foot surgery. While the operation is performed under general anaesthetic a small injection is directed behind the knee toward the sciatic nerve. This puts the foot to sleep for around 12-18 hours meaning that you wake up from surgery without pain and generally don't get much pain at all when the block wears off. This has made a large difference in the overall surgical experience reducing anxiety and improving recovery.

Recovery times

Unilateral

Bilateral

General

Result Times

These timeframes should be used as a guide only and may vary for individual patients based on the nature or extent of the actual surgery performed and individual circumstances. Please contact Mr Blackney's or Mr Bedi's rooms if you require further information.

• Patients should also read:
  Patient Information Sheet - Foot and Ankle Surgery: Pre and Post Operative Information
  Patient Infomation Sheet - Foot and Ankle Surgery: FAQ