A Refined Minimally Invasive Distal First Metatarsal Osteotomy for Moderate Hallux Valgus Treatment: The BC Procedure

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery
• Surgical Innovation

Background:

• Growing interest in minimally invasive surgery for hallux valgus correction.
• The Bösch technique is a recognized distal metatarsal osteotomy (DMO) for hallux valgus.
• Need for DMO techniques combining stability, correction power, and minimal invasiveness.

Purpose of the Study:

• To describe the novel BC technique, a DMO variant.
• To evaluate the surgical outcomes of the BC technique for hallux valgus.
• To report results at a minimum two-year follow-up.

Main Methods:

• Prospective evaluation of 63 patients with mild to moderate hallux valgus.
• Patients underwent the BC technique, a modified distal metatarsal osteotomy.
• Assessment included American Orthopedic Foot and Ankle Society (AOFAS) scores and first MTPJ range of motion (ROM) at minimum 2-year follow-up.

Main Results:

• Significant improvement in AOFAS scores from 47.4 preoperatively to 88 postoperatively (p < .05).
• First MTPJ ROM remained stable (32.5° preop vs. 31.8° postop, p > .65).
• 82% of patients reported satisfaction; all osteotomies achieved bony healing by 6 weeks.

Conclusions:

• The BC osteotomy is a safe and effective technique for mild and moderate hallux valgus.
• It provides stable, maintained correction with a simple, mini-invasive approach.
• The procedure demonstrates a low operative time and high patient satisfaction.