title: Revisional surgery for hallux valgus with serial osteotomies at two levels.
abstract: The aetiology and form of hallux valgus (HV) is varied with many corrective procedures described. We report a 39-year-old woman, previously treated with a Chevron osteotomy, who presented with recurrent right HV, metatarsus primus varus, and associated bunion. Osteotomies were performed at two levels as a revisional procedure. This report highlights (1) limitations of the Chevron osteotomy and (2) the revisional procedure of the two level osteotomies: (i) proximal opening-wedge basal osteotomy and (ii) distal short Scarf with medial closing wedges. If a Chevron osteotomy is used inappropriately, for example, in an attempt to correct too large a deformity, it may angulate laterally causing a malunion with an increased distal metatarsal articular angle. Secondly, it is feasible to correct this combined deformity using a combination of proximal opening-wedge and distal short Scarf osteotomies.
authors: University of Glasgow, Glasgow. limbengteck@doctors.org.uk
authors: Jason Beng Teck
authors: JB
authors: Lim
authors: James S
authors: JS
authors: Huntley
mesh_terms: D000328:Adult; D005260:Female; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D010027:Osteotomy; D011859:Radiography; D012086:Reoperation