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Long Z-osteotomy: a review and new modification to correct troughing
1Gundersen Lutheran Medical Center, La Crosse, WI 54601, USA. jksteck@gundluth.org
Summary
The long Z-osteotomy (scarf) effectively corrects hallux abducto valgus. A novel technique addresses troughing, a rare complication, by transferring the adductor hallucis tendon to salvage the procedure.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Surgery
Background:
- Hallux abducto valgus is a common foot deformity.
- Metatarsus primus varus is a key component of this deformity.
- The long Z-osteotomy (scarf) is an established surgical correction method.
Purpose of the Study:
- To review the historical context and technical aspects of the long Z-osteotomy.
- To describe a novel technique for managing intraoperative troughing during scarf osteotomy.
- To evaluate the benefits and potential complications of this modified approach.
Main Methods:
- Historical review of the long Z-osteotomy procedure.
- Description of a technique involving adductor hallucis tendon transfer for troughing.
- Discussion of surgical technique, fixation, range of motion, and weightbearing.
Main Results:
- The long Z-osteotomy offers strong internal fixation, early motion, and weightbearing.
- Troughing is an uncommon but challenging intraoperative complication.
- The described tendon transfer technique can salvage cases with troughing.
Conclusions:
- The long Z-osteotomy is an effective procedure for hallux abducto valgus.
- A modified technique for adductor hallucis tendon transfer can manage troughing.
- This modification has the potential to prevent a debilitating complication.