Bunion surgeries

Question 1

Proximal akin (indication)

Answer 1

corrects a large DASA

Question 2

Central akin (indication)

Answer 2

shortens a long proximal phalanx

Question 3

Distal akin (indication)

Answer 3

corrects a high hallux abductus angle

Question 4

Austin (what is it and indications)

Answer 4

V-shaped osteotomy with apex in center of met head and arms forming a 60 degree angle

Indicated if HAV with IMA 12-14

Question 5

Cheilectomy (what is it and indications)

Answer 5

removal of dorsal bone spur and dorsal 1/3 of 1st met head. May also remove prominences from proximal phalanx base. Indicated for Hallux limitus

Question 6

Closing base wedge/ Louisan-Balasceau

what is it and indications

Answer 6

closing wedge osteotomy straight across base of 1st met

Indicated for HAV with high IMA

Question 7

Crescentic (indications)

Answer 7

HAV with IMA >13

Question 8

DRATO (what is it and indications)

Answer 8

It is a derotational osteotomy of 1st met head

Indicated for a large IMA + abnormal PASA + valgus rotation of 1st met

Question 9

Hohmann (what is it and indications)

Answer 9

It is a transverse osteotomy of the metatarsal neck (unstable)

For HAV

Question 10

Juvara (what is it and indications)

Answer 10

it is a CBWO with the apex set proximal medial and the wedge set laterally

For a HAV > 15

Question 11

Kalish (what is it and indications)

Answer 11

similar to Austin but with a long dorsal arm for screw fixation.

HAV with IMA >15

Question 12

Keller ( what is it, specific patient population, and indications)

Answer 12

It is a resection of proximal 1/4-1/3 base of proximal phalanx and cheilectomy with capsular tissue sewn

Used in patients 50-55 years old

HAV with <16 IMA + hallux limitus/rigidus

Question 13

Kessel-Bonney (what is it, indications)

Answer 13

it is a removal of a pie shaped dorsiflexory wedge of bone from the proximal phalanx

Used for Hallux limitus

Question 14

Lambinudi (what is it and indications)

Answer 14

a plantarflexory wedge osteotomy of 1st met base

hallux limitus

Question 15

Lapidus (what is it and indications)

Answer 15

Fusion of 1st metatarsal base to medial cuneiform

HAV with 1st ray hypermobility

Question 16

Logroscino (what is it and indications)

Answer 16

Closing based wedge osteotomy to correct HAV with Reverdin to correct the cartilage orientation

HAV with IMA >15 in rectus foot with 13 adductus and abnormal PASA

Question 17

Loison (what is it and indications)

Answer 17

Transverse CBWO and used for HAV

Question 18

Ludloff (what is it, indications and comparison to Mau)

Answer 18

it is an oblique transpositional osteotomy (dorsal/proximal to plantar distal)

Used for HAV

opposite orientation to Mau

Question 19

Mau (what is it, indications and comparison to Ludloff)

Answer 19

it is an oblique rotational osteotomy (dorsal/distal to plantar proximal)

Used for HAV

opposite orientation to Ludloff

Question 20

McBride (what is it, and indications)

Answer 20

It is a Silver + soft tissue repair +capsular release/tightening

Question 21

McKeever (what is it and indications)

Answer 21

it is a 1st MPJ arthrodesis/ fusion where you position the hallux at 5-10 degrees abduction and 5-10 degrees dorsiflexion.

Used for HAV with dislocation and for Hallux limitus/rigidus

Question 22

Mitchell

Answer 22

for HAV

Question 23

Trethowan (what is it and indications)

Answer 23

it is an OBWO across base of 1st met

used for HAV

Question 24

Peabody (what is it and indications)

Answer 24

it is a reverdin done in the 1st met neck

used for an abnormal PASA

Question 25

Reverdin (what is it and indications)

Answer 25

it is a medial base wedge resection in 1st met head for mild HAV + abnormal PASA

Question 26

Reverdin Green (what is it and indications)

Answer 26

Reverdin osteotomy but with an L-shaped portion to preserve sesamoid articulation HAV with abnormal PASA

Question 27

Reverdin Laird (what is it and indication)

Answer 27

Reverdin green with lateral shift of the capital fragment to correct for IMA For Moderate HAV + abnormal PASA

Question 28

Reverdin-Green-Laird-Todd (what and indications)

Answer 28

Triangle shaped wedge from top and side of distal 1st met Correction of 3 planes For Hallux limitus + HAV

Question 29

Scarf (what is it and indications)

Answer 29

Z-type osteotomy through shaft of the 1st met (watch out for troughing) HAV with an IMA 12-18

Question 30

Silver (what and indications)

Answer 30

an isolated resection of medial eminence of 1st met head Used for medial 1st MPJ pain and mild HAV

Question 31

Stamm (what and indications)

Answer 31

OBWO in medial cuneiform | For HAV

Question 32

Valenti (what and indications)

Answer 32

Removal of angled dorsal wedges from 1st met and proximal phalanx to increase ROM Hallux limitis

Question 33

Vogler (what and indications)

Answer 33

V- osteotomy made in neck of 1st metatarsal. Similar to Kalish but more proximal HAV

Question 34

Watermann (What and indications)

Answer 34

removal of closing wedge of bone from 1st met head to dorsiflex the capital fragment Hallux limitus

Question 35

Watermann- Green (what and indications)

Answer 35

Watermann osteotomy but includes a plantar shelf to preserve sesamoid articulation Hallux limitus

Question 36

Wilson (what and indications)

Answer 36

Oblique cut from distal/medial to proximal/lateral For HAV + a long 1st met

Question 37

Youngswick (what and indications)

Answer 37

Austin but with extra slice take out on the dorsal arm to allow head to drop plantarly HAV+ DF 1st met HAV+ Hallux limitus

Question 38

Gerbert (what and indications)

Answer 38

Wedge osteotomy of 5th met base with K-wire or screw fixations For Tailor's bunion

Question 39

Mercado (what and indications)

Answer 39

Oblique wedge osteotomy at 5th met neck Tailor's bunion

Question 40

Reverse Austin (what and indications)

Answer 40

Transverse plane V- osteotomy tailors bunion

Question 41

Reverse Hohmann (what and indications)

Answer 41

Transverse osteotomy in distal metaphysis of 5th met. Fixation not used Tailor's bunion

Question 42

Reverse Wilson(what and indications)

Answer 42

Osteotomy from distal/ lateral to proximal medial to shorten 5th met and medial transposition Tailor's bunion

Question 43

Yancey (what and indications)

Answer 43

Oblique or transverse wedge osteotomy at 5th met proximal mid diaphyseal. Tailor's bunion