Opening first metatarsal osteotomy and resection arthroplasty of the first MPJ in the treatment of first ray insufficiency associated with degenerative hallux valgus

BackgroundOpening wedge proximal metatarsal osteotomy combined with first metatarsophalangeal arthroplasty can be used to correct first metatarsus primus varus with a high intermetatarsal angle and a short first metatarsal.Methods147 feet in 138 patients with degenerative first metatarsophalangeal arthrosis, ≥15° of metatarsus primus varus and, a short first metatarsal were included. Preoperative and postoperative clinical, radiographic, and subjective outcome measurements were taken (Scale AOFAS).ResultsThe mean first intermetatarsal angle decrease was 7.79 ± 1.43° and the mean increase in first metatarsal length was 2.88 ± 0.45 mm. The pre-intervention mean values were 52.6 points in the AOFAS scale, and an overall result of 92.95 obtained after surgery (P < 0.001).ConclusionsThe opening proximal first metatarsal osteotomy without internal fixation and with first metatarsophalangeal resection arthroplasty can correct severe hallux valgus with an intermetatarsal angle ≥15° and a short first metatarsal, achieving low rate of complications.