This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Carpenter, B. Articles by Motley, T. Search for Related Content PubMed PubMed Citation Articles by Carpenter, B. Articles by Motley, T.

Adding Stability to the Crescentic Basilar First Metatarsal Osteotomy

Brian Carpenter, DPM ^*  and Travis Motley, DPM ^*

^* Podiatry Section, Department of Orthopaedics, John Peter Smith Hospital, Fort Worth, TX.
Private practice, Decatur, TX.

Corresponding author: Brian Carpenter, DPM, Podiatry Section, Department of Orthopaedics, John Peter Smith Hospital, 1500 S Main St, Fort Worth, TX 76104.

Abstract

Crescentic basilar osteotomies for metatarsus primus varus and hallux valgus allow for substantial correction of the first intermetatarsal angle and the hallux valgus angle. Crescentic osteotomies have two well-documented pitfalls: sagittal plane instability and difficulty in fixation. We describe the addition of a plantar shelf to crescentic basilar osteotomy that allows for easier fixation and less risk of elevation of the first metatarsal postoperatively. This plantar shelf is made in the metaphyseal portion of the first metatarsal, which provides the benefit of better bone healing. In 20 patients, we found an average reduction in the intermetatarsal angle of 9.3° and an average reduction in the hallux valgus angle of 21.8°. Eight weeks postoperatively, only one patient showed elevation of the first metatarsal. (J Am Podiatr Med Assoc 94(5): 502–504, 2004)