Proximal Oblique Sliding Closing-wedge Osteotomy for Wide-angle Hallux Valgus


Proximal metatarsal osteotomies are generally recommended for treating severe hallux valgus deformities. The most common complications after surgery for such deformities are recurrence, hallux varus, or dorsal malunion. To decrease these complications, modifications have been made in the design, technique, and fixation procedure for this corrective surgery. In this article, we describe the proximal metatarsal osteotomy procedure known as the proximal oblique sliding closing-wedge (POSCOW) osteotomy, which was developed to include a proximal lateral displacement and a lateral closing-wedge osteotomy, thereby combining the effects of rotation and displacement of the hallux following preoperative planning. Plate fixation has been used in this procedure to improve fixation and decrease malunion. We report in detail the preoperative considerations, surgical technique, results, and complications of the POSCOW procedure.

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