Skip to main content
SpringerLink
Log in

Distal Metatarsal Osteotomy and Capsular Balancing

  • Chapter
  • First Online:
Evidence-Based Bunion Surgery

  • 1238 Accesses

Abstract

Distal metatarsal osteotomy has traditionally been indicated to address moderate hallux valgus deformity. Advantages of this procedure include the ability to control length and sagittal plane position, inherent stability to the osteotomy, technical simplicity, and early weight bearing. Shortcomings include many of the issues that have been discussed inherent to transverse plane procedures such as under-correction, loss of correction, and need for multiple procedures in many cases. One component of the procedure that is consistently needed during correction is detailed attention to soft tissue balancing. Discussion of the most common types of distal metatarsal correction for hallux valgus is presented.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Miller JW. Distal first metatarsal displacement osteotomy. J Bone Joint Surg Am. 1974;56(5):923–31.

    Article  CAS  PubMed  Google Scholar 

  2. Lewis RJ, Feffer HL. Modified chevron osteotomy of the first metatarsal. Clin Orthop Relat Res. 1981;157:105–9.

    Google Scholar 

  3. Magnan B, Pezzè L, Rossi N, Bartolozzi P. Percutaneous distal metatarsal osteotomy for correction of hallux valgus. J Bone Joint Surg Am. 2005;87(6):1191–9.

    PubMed  Google Scholar 

  4. Donnelly RE, Saltzman CL, Kile TA, Johnson KA. Modified chevron osteotomy for hallux valgus. Foot Ankle Int. 1994;15(12):642–5.

    Article  CAS  PubMed  Google Scholar 

  5. Glasoe WM, Nuckley DJ, Ludewig PM. Hallux valgus and the first metatarsal arch segment: a theoretical biomechanical perspective. Phys Ther. 2010;90(1):110.

    Article  PubMed  Google Scholar 

  6. Potenza V, Caterini R, Farsetti P, Forconi F, Savarese E, Nicoletti S, Ippolito E. Chevron osteotomy with lateral release and adductor tenotomy for hallux valgus. Foot Ankle Int. 2009;30(6):512–6.

    Article  PubMed  Google Scholar 

  7. Banks AS. McGlamry’s comprehensive textbook of foot and ankle surgery. Lippincott Williams & Wilkins: Philadelphia, 2001.

    Google Scholar 

  8. Mann RA, Coughlin MJ. Hallux valgus-etiology, anatomy, treatment and surgical considerations. Clin Orthop Relat Res. 1981;157:31–41.

    Google Scholar 

  9. Kalish SR, Spector JE. The Kalish osteotomy. A review and retrospective analysis of 265 cases. J Am Podiatr Med Assoc. 1994;84(5):237–42.

    Article  CAS  PubMed  Google Scholar 

  10. Hetman J, Myer KD. The distal metatarsal osteotomy for the treatment of hallux valgus. Clin Podiatr Med Surg. 2005;22(2):143–67.

    Article  PubMed  Google Scholar 

  11. Reverdin J. De la deviation en dehors du gros orl (hallux valgus) et son traitement chirurgical. Trans Int Med Congr. 1881;2:408–4123.

    Google Scholar 

  12. Beck E. Modified Reverdin technique for hallux abducto valgus (with increased proximal articular set angle of the first metatarsophalangeal joint). J Am Podiatry Assoc. 1974;64:657.

    Article  CAS  PubMed  Google Scholar 

  13. Laird P, Silvers S, Somdahl J. Two Reverdin-Laird osteotomy modifications for correction of hallux abducto valgus. J Am Podiatry Assoc. 1988;78:403.

    Article  CAS  Google Scholar 

  14. Lombardi CM, Silhanek AD, Connolly FG, Suh D, Violand M. First metatarsocuneiform arthrodesis and Reverdin-Laird osteotomy for treatment of hallux valgus: an intermediate-term retrospective outcomes study. J Foot Ankle Surg. 2003;42(2):77–85.

    Article  PubMed  Google Scholar 

  15. Bauer T, Biau D, Lortat-Jacob A, Hardy P. Percutaneous hallux valgus correction using the Reverdin-Isham osteotomy. Orthop Traumatol Surg Res. 2010;96(4):407–16.

    Article  CAS  PubMed  Google Scholar 

  16. Hawkins FB, Mitchell CL, Hedrick DW. Correction of hallux valgus by metatarsal osteotomy. J Bone Joint Surg Am. 1945;27:3879.

    Google Scholar 

  17. Merkel KD, Katoh Y, Johnson EW. Mitchell osteotomy for hallux valgus: long-term follow-up and gait analysis. Foot Ankle. 1983;3:189–19610.

    Article  CAS  PubMed  Google Scholar 

  18. Heerspink FL, Verburg H, Reininga IHF, van Raaij TM. Chevron versus Mitchell osteotomy in hallux valgus surgery: a comparative study. J Foot Ankle Surg. 2015;54(3):361–4.

    Article  Google Scholar 

  19. Shapiro F, Heller L. The Mitchell distal metatarsal osteotomy in the treatment of hallux valgus. Clin Orthop. 1975;107:225–23126.

    Article  Google Scholar 

  20. Austin DW, Leventen EO. A new osteotomy for hallux valgus: a horizontally directed “V” displacement osteotomy of the metatarsal head for hallux valgus and primus varus. Clin Orthop. 1981;157:25–302.

    Google Scholar 

  21. Youngswick FD. Modifications of the Austin bunionectomy for treatment of metatarsus primus elevatus associated with hallux limitus. J Foot Surg. 1982;21(2):11418.

    Google Scholar 

  22. Jahss MH. Disorders of the hallux and the first ray, ch 39. In: Jahss MH, editor. Disorders of the foot and ankle: medical and surgical management. 2nd ed. Philadelphia: WB Saunders Co; 1991. p. 943–117325.

    Google Scholar 

  23. Muhlbauer M, Zembsch A, Trnka HJ. Kurzfristige Ergebnisse der modifizierten Chevron- Osteotomie mit Weichteiltechnik und Bohrdrahtfixation-eine prospektive Studie. [Short-term results of modified chevron osteotomy with soft tissue technique and guide wire fixation–a prospective study]. Z Orthop Ihre Grenzgeb. 2001;139:435–9.

    Article  CAS  PubMed  Google Scholar 

  24. Klein MS, Ognibene FA, Erali RP, et al. Self-tapping screw fixation of the Austin osteotomy. J Foot Surg. 1990;29:52–4.

    CAS  PubMed  Google Scholar 

  25. Harper MC. Correction of metatarsus primus varus with the Chevron metatarsal osteotomy: an analysis of corrective factors. Clin Orthop Relat Res. 1989;243:180–3.

    Google Scholar 

  26. Meier PJ, Kenzora JE. The risks and benefits of distal first metatarsal osteotomies. Foot Ankle Int. 1985;6(1):7–17.

    Article  CAS  Google Scholar 

  27. Oloff LM, Bocko AP. Application of distal metaphyseal osteotomy for treatment of high intermetatarsal angle bunion deformities. J Foot Ankle Surg. 1998;37(6):481–9.

    Article  CAS  PubMed  Google Scholar 

  28. Stienstra JJ, Lee JA, Nakadate DT. Large displacement distal chevron osteotomy for the correction of hallux valgus deformity. Foot Ankle. 2002;41:213–22023.

    Google Scholar 

  29. Boberg JS, Judge MS. Follow-up of the isolated medial approach to hallux abducto valgus correction without interspace release. J Am Podiatr Med Assoc. 2002;92(10):555–62.

    Article  PubMed  Google Scholar 

  30. Hattrup SJ, Johnson KA. Chevron osteotomy: analysis of factors in patients’ dissatisfaction. Foot Ankle. 1985;5(6):327–32.

    Article  CAS  PubMed  Google Scholar 

  31. Hirvensalo E, Bostman O, Tormala P. Chevron osteotomy fixed with absorbable polyglycolide pins. Foot Ankle. 1991;11:212–21827.

    Article  CAS  PubMed  Google Scholar 

  32. Williams WW, Barrett DS, Copeland SA. Avascular necrosis following chevron distal metatarsal osteotomy: a significant risk? J Foot Surg. 1988;28(5):414–6.

    Google Scholar 

  33. Peterson DA, Zilberfarb JL, Greene MA, Colgrove RC. Avascular necrosis of the first metatarsal head: incidence in distal osteotomy combined with lateral soft tissue release. Foot Ankle Int. 1994;15(2):59–63.

    Article  CAS  PubMed  Google Scholar 

  34. Easley ME, Kelly IP. Avascular necrosis of the hallux metatarsal head. Foot Ankle Clin. 2000;5(3):591–608.

    CAS  PubMed  Google Scholar 

  35. Jones KJ, Feiwell LA, Freedman EL. The effect of chevron osteotomy with lateral capsular release on the blood supply to the first metatarsal head. J Bone Joint Surg Am. 1995;77:197–204.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Foot & Ankle Institute, Western Pennsylvania Hospital, Pittsburgh, PA, USA

    Alan R. Catanzariti DPM, FACFAS & Lisa M. Grant DPM

Authors
  1. Alan R. Catanzariti DPM, FACFAS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lisa M. Grant DPM
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alan R. Catanzariti DPM, FACFAS .

Editor information

Editors and Affiliations

  1. College of Podiatric Medicine and Surgery, Des Moines University, Des Moines, Iowa, USA

    Paul D. Dayton

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Catanzariti, A.R., Grant, L.M. (2018). Distal Metatarsal Osteotomy and Capsular Balancing. In: Dayton, P. (eds) Evidence-Based Bunion Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-60315-5_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-60315-5_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-60314-8

  • Online ISBN: 978-3-319-60315-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation