Literature Review: Double Osteotomy of the First Metatarsal for Hallux Abducto Valgus

Caroline Ko, B.S., Isaiah Song, B.S.

A double osteotomy of the first metatarsal is a combined procedure of a proximal and distal osteotomy of the first metatarsal. The technique provides a large angular correction for severe cases of hallux abducto valgus while minimizing the rate of recurrence and preserving the first metatarsophalangeal joint articulation. Historically, this procedure has had major complications, including shortening of the first metatarsal, stiffness of the first metatarsophalangeal joint, and avascular necrosis of the first metatarsal head. The traditional double osteotomy of the first metatarsal has evolved
with the goal of minimizing the aforementioned complications. The Peterson approach maintains the length of the metatarsal while preserving the recurrence rate.
The modified Peterson approach incorporates a medial plate and screws and reduces first metatarsophalangeal joint stiffness. Minimally invasive percutaneous approaches
of the procedure have been suggested to lower risk of avascular necrosis. This literature review provides an overview of double osteotomies of the first metatarsal and a discussion of associated outcomes and complications.