Hallux Valgus With Increased Intermetatarsal Angle: Surgical Treatment With Proximal Opening Wedge Metatarsal Osteotomy

Hallux valgus is a common cause of foot pain and deformity in the adult and adolescent population, which often requires surgical treatment when nonsurgical treatments fail. When the condition is associated with an increased intermetatarsal angle, a surgical technique using a proximal first metatarsal osteotomy is often indicated. A proximal opening wedge osteotomy stabilized with a wedge and plate configuration offers a stable, reliable means to correct the increased intermetatarsal angle. This article describes a technique for surgical correction of hallux valgus with an increased metatarsal angle, using a 3-incision technique that includes: (1) a medial bunionectomy with capsular imbrication, (2) a lateral soft-tissue release, and (3) a proximal metatarsal osteotomy fixed with a 4-hole L-shaped plate with a wedge spacer.