Hallux valgus

Last evidence check March 2010

The crescentic osteotomy was designed to avoid the shortening that accompanies the closing wedge osteotomy. However, it is still open to the risk of dorsal malunion. McCluskey(1994) and Acevedo (2002) showed it to be less stable than the proximal chevron or scarf procedures.

Easley compared the crescentic with the proximal chevron osteotomy in a RCT of 93 patients. Clincal results were the same; radiographic measurements tended to favour the proximal chevron but the difference was non-significant.

At 11-14 years over 90% were satisfied and there was a low rate of recurrence and transfer lesions. (Veri 2001).

Despite the theoretical disadvantages, the crescentic osteotomy offers good clinical results in most series which seems to be maintained at long term follow-up. There is a good case for viewing it as the gold standard proximal osteotomy.