title: Comparison of Postoperative Height Changes of the Second Metatarsal Among 3 Osteotomy Methods for Hallux Valgus Deformity Correction.
abstract: BACKGROUND
  We aimed to compare the postoperative height of the second metatarsal head relative to the first metatarsal head using axial radiographs among 3 different commonly used osteotomy techniques: proximal chevron metatarsal osteotomy (PCMO), scarf osteotomy, and distal chevron metatarsal osteotomy (DCMO).
  
  
  METHODS
  We retrospectively reviewed the radiographs and clinical findings of the patients with painful callosities under the second metatarsal head, complicated by hallux valgus, who underwent isolated PCMO, scarf osteotomy, or DCMO from February 2005 to January 2015. Each osteotomy was performed with 20 degrees of plantar ward obliquity. Along with lateral translation and rotation of the distal fragment to correct the deformity, lowering of the first metatarsal head was made by virtue of the oblique metatarsal osteotomy.
  
  
  RESULTS
  Significant postoperative change in the second metatarsal height was observed on axial radiographs in all groups; this value was greatest in the PCMO group (vs scarf: P = .013; vs DCMO: P = .008) but did not significantly differ between the scarf and DCMO groups ( P = .785). The power for second metatarsal height correction was significantly greater in the PCMO group (vs scarf: P = .0005; vs DCMO: P = .0005) but did not significantly differ between the scarf and DCMO groups ( P = .832).
  
  
  CONCLUSIONS
  Among the 3 osteotomy techniques commonly used to correct hallux valgus deformity, we observed that PCMO yielded the most effective height change of the second metatarsal head.
  
  
  METHODS
  Level III, retrospective comparative series.
authors.affiliation: 1 W institute for foot and ankle disease and trauma, W Hospital, Daegu, South Korea.
authors.forename: Jun Young
authors.initials: JY
authors.lastname: Choi
authors.affiliation: 2 New York University School of Medicine, New York, NY, USA.
authors.forename: Yu Min
authors.initials: YM
authors.lastname: Suh
authors.affiliation: 3 Department of Orthopedic Surgery, Inje University, Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, South Korea.
authors.forename: Ji Woong
authors.initials: JW
authors.lastname: Yeom
authors.affiliation: 3 Department of Orthopedic Surgery, Inje University, Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, South Korea.
authors.forename: Jin Soo
authors.initials: JS
authors.lastname: Suh
mesh_terms: D000328:Adult; D005529:Foot Bones / Q000000981:diagnostic imaging; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008682:Metatarsal Bones / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000601:surgery; D008683:Metatarsophalangeal Joint / Q000601:surgery; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies
keywords: hallux valgus; lesser metatarsals; painful plantar callosity; proximal chevron osteotomy