The inverted Z bunionectomy: quantitative analysis of the scarf and inverted scarf bunionectomy osteotomies in fresh cadaveric matched pair specimens.

Quantitative analyses of the Scarf/Z and inverted Scarf/Z bunionectomy osteotomy procedures utilizing two-screw fixation were performed in fresh cadaveric specimens. Eighteen trials (nine matched pair feet) were used for direct comparison. Ultimate strength and failure areas were examined. Trial results revealed a strong statistically significant positive effect. The inverted Z approach was found, on average, 1.6 times stronger in resisting simulated weightbearing forces on the capital fragment to failure than that of the traditional Z bunionectomy osteotomy.