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Chevron osteotomy
23%
65/284
Diaphyseal osteotomy
34%
96/284
Metatarsal head resection
6%
16/284
Exostectomy of the lateral eminence
14%
39/284
Exostectomy of the lateral eminence with a fifth toe extensor tenotomy and capsular release
22%
63/284
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The most appropriate treatment is a diaphyseal osteotomy. The patient has a painful bunionette with a large 4-5 intermetatarsal (IM) angle (a type 3 bunionette) that is best treated with a diaphyseal or proximal osteotomy. Exostectomy of the lateral eminence applies to type 1 bunionettes that can also have a fifth hammer toe. A Chevron osteotomy is best used for a type 1 or 2 bunionette with a normal 4-5 IM angle. A metatarsal head resection is not indicated as a primary procedure for a bunionette, especially in a younger patient because it sacrifices the fifth metatarsophalangel joint.
1.4
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