Does First Metatarsal Head Lowering During Minimally Invasive Chevron Akin Osteotomy Yield No Significant Difference in Patient-reported Outcomes Compared With Second Distal Metatarsal Minimally Invasive Osteotomy for Treating Intractable Plantar Keratosis?

The authors investigate whether minimally invasive chevron Akin osteotomy (MICA) with first metatarsal head lowering yields different patient-reported outcomes compared to MICA combined with second distal metatarsal minimally invasive osteotomy (DMMO) in treating intractable plantar keratosis associated with hallux valgus. They found that while both procedures effectively resolved keratosis, they differed in their impact on metatarsal height and functional outcomes, with first metatarsal head lowering showing greater improvement in sports-related activities but also leading to more discomfort beneath the first metatarsal. The study highlights the importance of assessing metatarsal height when choosing surgical techniques for this condition.