Six First Metatarsal Shaft Osteotomies

Rotational Scarf and Akin Osteotomy for Correction of Hallux Valgus Associated with Metatarsus Adductus

“…In the management of mild to moderate hallux valgus deformities, more distal procedures have been recommended. 40,46 Distal procedures hold a strong position in the management of hallux valgus, however, with more distal procedures there is a limitation as to how much correction can be achieved due to the limitation in the amount of displacement available before the osteotomy becomes unstable. 27,40 The first paper published on the transpositional scarf was by Zygmunt.…”

Comparison of the Proximal Chevron and Ludloff Osteotomies for the Correction of Hallux Valgus

“…In the Ludloff osteotomy, lag screw fixation had been widely used because of its strength, versatility, low tissue reactivity, and ability to create compression across the osteotomy site. 8 Although this is technically demanding and has often been reported to result in malunion with dorsal angulation of the first metatarsal, 33 the engagement of the screw threads into the strong cortical bone offered a theoretical advantage compared to Kirschner wire fixation. Moreover, if screw-head irritation occurs, it is easy, compared to Kirschner wire fixation, to remove the screw.…”

Plantar pressure distribution and pain after distal osteotomy for hallux valgus

“…In theory, depression should decrease transfer metatarsalgia. Despite the fact that more clinical studies are needed to evaluate it, there is general consensus in the orthopaedic literature that feet with hallux valgus have decreased weight bearing of the big toe and the first metatarsal, causing transfer of weight bearing pressure to the adjacent second metatarsal 1,13,25,60,68,98,101,103,107 . Numerous authors cite pressurerelated topics under the first metatarsal head, the big toe, and second metatarsal head as measures of judging failure and success of bunion surgery.…”

“…Numerous authors cite pressurerelated topics under the first metatarsal head, the big toe, and second metatarsal head as measures of judging failure and success of bunion surgery. These include transfer metatarsalgia under the second metatarsal 1,18,25,54,98,101,103 , elevation of the first metatarsal 6,13,25,60,68,98,101 , and decreased weight bearing on the big toe and/or first metatarsal as sources of failure 1,13,25,54,60,98,101 . Conversely, plantar flexion of the first metatarsal 24,60 increased weight bearing pressure under the big toe and first metatarsal head 24 , and improvement of second metatarsalgia are cited as proof of surgical success 24 .…”