The offset "V" bunionectomy using cortical screw and buried Kirschner wire fixation.

The offset "V" bunionectomy with cortical screw and buried Kirschner wire fixation offers advantages over previously described distal metatarsal procedures for correction of hallux abducto valgus. The ability to correct an increased intermetatarsal angle (IMA) as well as a proximal articular set angle (PASA) deviation allows for the eradication of postoperative deforming forces, which often lead to recurrence of the deformity. Complete soft tissue release and repair allows for the repositioning of the sesamoidal apparatus, and also reduces the tendency for recurrence. The authors have performed approximately 500 of these procedures in the past 7 years and found it to provide extremely satisfying results. Gaining experience in the aforementioned techniques has lessened the need for base osteotomies and more unstable types of distal osteotomies. The criterion for the use of this osteotomy continues to broaden as the authors gain experience with its use. The offset "V" osteotomy is now utilized as either a primary or ancillary procedure in approximately 90% of the hallux valgus patients upon whom the authors operate.