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Updated: Jun 22, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Metatarsus primus varus correction: the osteotomies.

Matthew D Sorensen1, Christopher F Hyer

  • 1Advanced Foot and Ankle Surgery Fellowship, Orthopedic Foot and Ankle Center, Westerville, OH 43082, USA.

Clinics in Podiatric Medicine and Surgery
|June 10, 2009
PubMed
Summary

Surgical correction of hallux valgus and metatarsus primus varus requires first-ray realignment. This review focuses on first-metatarsal osteotomies, advocating for proximal osteotomy with soft tissue balancing for successful outcomes.

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Radiographic analysis of hallux valgus and first tarsometatarsal joint correction after isolated first metatarsophalangeal joint arthrodesis.

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons·2025

Area of Science:

  • Orthopedic Surgery
  • Foot and Ankle Surgery
  • Skeletal Biomechanics

Background:

  • Hallux valgus and metatarsus primus varus are common foot deformities.
  • Surgical correction involves complex biomechanical considerations of the first ray.
  • Multiple surgical techniques exist, necessitating a review of their efficacy.

Purpose of the Study:

  • To review first-metatarsal osteotomies for hallux valgus and metatarsus primus varus correction.
  • To present arguments supporting proximal osteotomy techniques.
  • To emphasize the importance of soft tissue balancing in conjunction with osteotomy.

Main Methods:

  • Literature review of surgical techniques for first-ray deformities.
  • Analysis of biomechanical principles in first-metatarsal osteotomies.

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  • Summary of evidence supporting proximal osteotomy and soft tissue procedures.

    • Main Results:

    • First-metatarsal osteotomies are a primary surgical option for these deformities.
    • Proximal osteotomies offer effective correction and stabilization of the first ray.
    • Combined proximal osteotomy with soft tissue balancing yields favorable outcomes.

    Conclusions:

    • Successful surgical correction of hallux valgus and metatarsus primus varus hinges on first-ray realignment and stabilization.
    • Proximal first-metatarsal osteotomy, coupled with meticulous soft tissue balancing, represents a robust approach.
    • This strategy addresses the underlying biomechanical issues for improved patient results.