Hallux valgus, basal osteotomy - operative indications

A basal osteotomy can be used as personal preference dictates to some extent.

More often it is used for severe Hallux valgus deformities with IM angles in excess of 20 degrees. Using a basal opening wedge for the osteotomy as described here will always have the effect of making the distal metatarsal articular angle more valgus. This may increase the tendency for the hallux itself to angle laterally. It is easily counteracted by an Akin osteotomy, which is an acceptable price for the increased potential correction of the intermetatarsal angle over diaphyseal osteotomies. Non opening wedge basal osteotomies do not carry this issue with them. The simplicity and reproducibility of the Arthrex basal plate however merits its serious consideration for this procedure.

The upper limit of its use, after which consider acute corrective MTP fusion with lateral release, is 26-28 degrees.