Comparison of oblique closing base wedge osteotomies of the first metatarsal: stripping versus nonstripping of the periosteum

The authors present a study comparing two methods of performing the oblique closing base wedge osteotomy of the first metatarsal for correction of hallux abducto valgus deformity. In one group, the periosteum was stripped from the metatarsal prior to performing the osteotomy, and in the other group, the osteotomy was performed through the periosteum. Sixty-five osteotomies are included in the study. This article discusses the closing base wedge osteotomy, fracture healing and the role of the periosteum, the blood supply to the first metatarsal, and the effects of periosteal stripping. Also included is a presentation of the surgical technique used, a statistical review of the procedures performed, a critical discussion summarizing the results, and a discussion of the postoperative complications encountered.