Chevron osteotomy for bunionette

Numerous procedures have been described for the surgical treatment of symptomatic bunionettes. We describe the technique, results, and follow-up of patients treated with a chevron osteotomy of the distal fifth metatarsal. This surgical approach to the treatment of bunionette is presented as a viable alternative to other surgical procedures. Sixteen distal fifth metatarsal chevron osteotomies were performed on 12 patients. Follow-up was from 15 months to 6 years, with an average follow-up of 3.2 years. A 100-point scoring system was devised and the average score improved from 44 points before surgery (range 20-65) to 91 points after surgery (range 65-100). There was one complication of a transfer metatarsalgia. The overall results were good to excellent, except for the transfer metatarsalgia, which was rated as fair. We have used the procedure in a laterally deviated, plantar metatarsal. There is concern that alternatives be used in a laterally deviated, plantarflexed fifth metatarsal. We have continued to use the chevron osteotomy with this condition.