How I Use a Three-Dimensional Approach to Correct Hallux Valgus with a Distal Metatarsal Osteotomy

The role of uniplanar osteotomy in correction of multiplanar deformity in hallux valgus is a developing and promising concept. Careful consideration should be given to the literature when considering the concept of preexisting pronation of the metatarsal. Recent weight-bearing computed tomography studies contradict the existing literature and state that there is little or no rotation of the metatarsal; therefore, a multiplanar osteotomy should aim to correct the rotation caused by soft tissue imbalance at the tarsometatarsal and metatarsophalangeal joints rather than in the metatarsal itself. A minimally invasive technique used by the senior author to achieve this correction is reported.