Basal osteotomy for Hallux Valgus using Arthrex Low Profile Locking Proximal Opening Wedge Osteotomy Plate surgical technique
Subscribe to get full access to this operation and the extensive Foot Surgery Atlas.
Learn the Basal osteotomy for Hallux Valgus using Arthrex Low Profile Locking Proximal Opening Wedge Osteotomy Plate surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Basal osteotomy for Hallux Valgus using Arthrex Low Profile Locking Proximal Opening Wedge Osteotomy Plate surgical procedure.
A basal metatarsal osteotomy of the first ray is an operation for moderate to severe Hallux Valgus deformity, and most commonly is either a medially based opening wedge or a laterally based closing wedge. Less commonly performed, and more technically challenging designs of osteotomy also exist, in particular the basal chevron and the cresentic basal osteotomy.
The choice of an opening wedge osteotomy (as demonstrated in this technique) avoids the shortening of the 1st Ray which can occur with the use of a closing wedge osteotomy, but careful soft tissue balancing is required with the opening wedge.
Though the inter-metatarsal angle is well corrected (as long as an appropriately large size of open wedge plate is selected) inevitably the distal metatarsal articular angle (DMAA) is angulated more into valgus which means almost always an Akin osteotomy, or distal metatarsal osteotomy, is also required. An Akin is often also required to address pronation of the hallux which can be marked with larger deformities. Other procedures are always required to rebalance the soft tissues in particular a modified McBrides procedure and medial capsular plication (in common with most operations for Hallux Valgus correction) and on occasion careful Z-lengthening of the extensor tendons to the hallux.
Some Surgeons will routinely combine a basal osteotomy with a distal metatarsal osteotomy to correct severe deformity, though I have not found the need if using the other techniques described.
Alternate operations used for severe deformities are commonly either a corrective first MTP fusion or a Lapidus procedure, or in some peoples hands a Scarf osteotomy.
Readers will also find these other OrthOracle surgical techniques give useful, alternative perspectives Scarf osteotomy , Lapidus fusion using the I.O. Fix implant (Extremity Medical) , First MTP Fusion :Coughlin reamer preparation and Orthosolutions Cannulated 4mm screws. ,First MTP Fusion-Crossed screws technique. First MTP Fusion (using Stryker Anchorage MTP arthrodesis plate )for Hallux Varus .
Author: Mark Herron FRCS
Institution: The Wellington Hospital, London, UK.
- Each operation and the questions associated become a named course in the CPD section
- The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
- You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
- The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
- There are four possible answers of which one is correct (or on occasion more correct) than the others.
- There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
- The course is completed once all the lessons are read and quizzes submitted and passed.
- On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
- Your dashboard also will contain a record of the time you have spent logged onto and using the site.
- The timer suspends after 5 minutes though if there is no activity.
- When you restart you will resume at the same point in the module.
- Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
The pass mark is 75%.
- If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
- Once these have been read you can re-do just the questions you failed on.
- Once you have passed the quiz you can return at a future stage & resit .
- Operation Quiz – 1 CPD point
- Surgical steps Quiz – 1/4 CPD point
- Implants Quiz – 1/4 CPD point
- Problem case Quiz – 1/2 CPD point
One CPD point equates to one hour of academic activity
Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.
Our content is designed for both Surgeons in independent practice and Surgeons in training.