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Updated: Nov 4, 2025

Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy
Published on: February 17, 2023
[Correction of the pre- and post-surgical rotational component of the first metatarsal secondary to modified Chevron
A G Espinosa-Uribe1,2, J I Ortiz-Garza2,3, M García-Limón2,3
1Universidad de Monterrey, Escuela de Medicina, Especialidades Médicas. México.
Introduction.:
Hallux valgus (HV) is a complex forefoot pathology, in which interest has recently been shown in the distal rotational component (CR) of the first metatarsal due to its relationship with postsurgical relapses of the deformity. The selection of surgical technique is controversial with little current literature on the correction of rotation with common osteotomies. The aim of this study is to evaluate preoperative and postoperative radiological characteristics regarding CR of the first metatarsal using long Chevron osteotomy for moderate to severe HV.
Material And Methods:
An observational, prospective and comparative study was carried out in which the CR of the first metatarsal was evaluated in nine feet belonging to six patients with a mean age of 45 years. The RC was evaluated based on the proximal metaphysis of the first metatarsal in axial fluoroscopies of unloaded metatarsals and standing AP. Measurements were performed by an Orthopedic and Traumatology resident and a Foot and Ankle Surgery subspecialist.
Results:
Significant differences (p = 0.05) were documented in the preoperative and postoperative pronation angle when using long Chevron osteotomy. The functional result of the evaluated patients was excellent at 11 months of follow-up.
Conclusions:
Radiologically, the rotational correction is variable and has not previously been reported in the literature with this osteotomy. We establishes the morphological bases for the performance of subsequent studies in the evaluation of head rotation of the 1st metatarsal with different osteotomies.

