A Modified Technique for the Treatment of Severe Adolescent Hallux Valgus: A Modification of the First Metatarsal Double Osteotomy

Adolescent hallux valgus is a deformity of childhood that is often difficult to treat conservatively because of its progressive nature and surgically because of its high risk of complications. Despite numerous procedures described, there is still little consensus on the best technique available for deformity correction. One of the standard procedures to address severe adult hallux valgus was described by Peterson and Newman in 1993. This procedure involved an excision of the medial eminence, an extra-articular distal closing wedge osteotomy to correct the hallux valgus, and a proximal transverse opening wedge osteotomy to correct the metatarsus primus varus. Although good outcomes have been reported, this approach is not without its own complications, including first metatarsophalangeal joint stiffness, avascular necrosis of the first metatarsal head, and painful pin removal. This paper presents a modification to the first metatarsal double osteotomy surgical technique (used by the principal investigator) to address severe adolescent hallux valgus. This technique avoids the complications associated with the traditional Peterson double osteotomy technique, whereas optimizing patient outcomes.
Level of Evidence: Level IV—Technique paper/case series with no control group. Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Source: Techniques in Foot and Ankle Surgery - June 1, 2018 Category: Orthopaedics Tags: CME Article Source Type: research