Avascular necrosis of the first metatarsal head. A different perspective

Avascular necrosis of the first metatarsal head has been reported as a potential complication associated with osteotomies at the first metatarsal head for repair of hallux abducto valgus deformity. However, most if not all of the radiographic and clinical findings associated with avascular necrosis at this level may also be explained by other processes. A critical review of avascular necrosis of the first metatarsal head is presented in conjunction with a discussion of alternative etiologies for the radiographic and clinical findings that may be noted following capital osteotomies.