The crescentic shelf osteotomy.

The authors describe a new surgical technique for the correction of a hallux abducto valgus deformity. The crescentic "shelf" osteotomy combines a dorsal-to-plantar crescentic osteotomy with a medial-to-lateral transverse osteotomy at the first metatarsal base. This technique allows triplanar correction, stable open reduction with internal fixation, and precise intermetatarsal reduction. This article discusses alternate base osteotomies, anatomical considerations of the first metatarsal, and data predicting frontal and sagittal plane motion of the distal fragment. Also included is a procedural guide followed by examples and possible complications. An analysis of 22 procedures are presented. The article briefly introduces the capital crescentic shelf osteotomy with review of the procedure.