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Gary M. Lepow, DPM, MS, FACFAS – Past President of ACFAS Houston, TX

A longitudinal incision is made over the first metatarsophalangeal (MTP) joint, just medial to the extensor hallucis longus tendon.  The incision is deepened to the joint.  A dorsal medial capsulotomy is performed and the joint is dissected free on the dorsal and medial aspects.

All hypertrophic bone is resected from the first metatarsal head and the base of the proximal phalanx.  Using a surgical saw, osteotomies are then performed perpendicular to the weight bearing surface to enable complete resection of the articular surfaces from the first metatarsal head and base of the proximal phalanx.  All resected bone surfaces are smoothed with a rasp. If desired, the Implant Sizer may be used to estimate the overall width of the osteotomy for the anticipated size Implant.

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