Publication:
Surgical Technology International XVI - Orthopaedic Surgery
Article title:
Proximal Opening-Wedge Osteotomy of the First Metatarsal for Correction of Hallux Valgus
Author(s)
Minton T. Cooper, M.D.
Resident
Orthopedic Foot and Ankle Center,
Ohio State University Department of Orthopaedics,
Columbus, Ohio, USA
Gregory C. Berlet, M.D.
Chief, Section Foot and Ankle and Clinical Assistant Professor
Ohio State University Department of Orthopedics,
Orthopedic Foot and Ankle Center,
Columbus, Ohio, USA
Paul S. Shurnas, M.D.
Director, Foot and Ankle Services
Columbia Orthopaedic Group,
Columbia, Missouri, USA
Thomas H. Lee, M.D.
Orthopedic Foot and Ankle Center,
Columbus, Ohio, USA
Abstract
Osteotomy of the proximal metatarsal in combination with a distal soft tissue procedure for the correction of moderate to severe hallux valgus deformity is commonly performed. All described techniques have complications such as non-union and malunion, and many are extremely technically demanding. The purpose of this study is to review the results of a novel technique for the correction of hallux valgus, an opening-wedge osteotomy of the proximal first metatarsal with plate fixation. A review was performed of the results of 23 patients who underwent correction of hallux valgus with proximal metatarsal opening-wedge osteotomy, in combination with a distal soft tissue procedure and exostectomy, if indicated. All osteotomies were secured with plate fixation on the medial side. Indications for surgery included a painful bunion for greater than one year and the failure of nonoperative treatment. Mean corrections of 15° and 7° were achieved for the hallux valgus and 1-2 intermetatarsal angles, respectively. Four complications occurred, including one wound dehiscence, two incidences of drifting of the hallux valgus angle, and one delayed union. We find the opening-wedge osteotomy of the proximal first metatarsal to be a technically straightforward procedure for correcting moderate to severe hallux valgus. The correction obtained is comparable to other described techniques with a complication rate equal to or lower than most published data at this time.