Technique Tip: Medial prominence bone spur resection in the third-generation percutaneous Chevron-Akin Osteotomy Technique (PECA) for hallux valgus correction

Foot Ankle Surg. 2022 Jun;28(4):460-463. doi: 10.1016/j.fas.2021.11.004. Epub 2021 Nov 21.


The third-generation percutaneous chevron and Akin osteotomy (PECA) technique for surgical management of hallux valgus has shown improvement in clinical and radiographic outcomes. During this procedure, lateral translation and fixation of the first metatarsal head results in the formation of a bony prominence on the medial side of the distal aspect of the first metatarsal which can cause pain and discomfort to the patient. We describe two techniques to address this bony prominence; either i) excision osteotomy and removal of the fragment or ii) a dorsal closing wedge osteotomy retaining the bony fragment. LEVEL OF EVIDENCE: Level V, expert opinion.

Keywords: Bunion; Hallux valgus; Minimally invasive; Percutaneous surgery.

MeSH terms

  • Exostoses*
  • Hallux Valgus* / diagnostic imaging
  • Hallux Valgus* / surgery
  • Humans
  • Metatarsal Bones* / diagnostic imaging
  • Metatarsal Bones* / surgery
  • Osteophyte*
  • Osteotomy / methods
  • Treatment Outcome