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Updated: Oct 11, 2025
An Anatomical Study of Nerves at Risk During Minimally Invasive Hallux Valgus Surgery
Published on: February 17, 2018
Technique Tip: Medial prominence bone spur resection in the third-generation percutaneous Chevron-Akin Osteotomy
Gabriel Ferraz Ferreira1, Gustavo Araujo Nunes2, Mauro Cesar Mattos E Dinato3
1Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil; Minimally Invasive Foot Ankle Society (MIFAS by GRECMIP), Brazil.
Abstract:
The third-generation percutaneous chevron and Akin osteotomy (PECA) technique for surgical management of hallux valgus has shown improvement in clinical and radiographic outcomes. During this procedure, lateral translation and fixation of the first metatarsal head results in the formation of a bony prominence on the medial side of the distal aspect of the first metatarsal which can cause pain and discomfort to the patient. We describe two techniques to address this bony prominence; either i) excision osteotomy and removal of the fragment or ii) a dorsal closing wedge osteotomy retaining the bony fragment. LEVEL OF EVIDENCE: Level V, expert opinion.
