Iatrogenic metatarsus primus elevatus. Etiology, evaluation, and surgical management.

Iatrogenic metatarsus primus elevatus is an infrequent but devastating complication of first ray surgery. The authors address their clinical and radiographic evaluation of metatarsus primus elevatus, and describe a surgical treatment with emphasis on the sagittal plane Z-osteotomy. This osteotomy provides predictable and versatile correction for the treatment of iatrogenic deformities of the first metatarsal. It allows for plantarflexion and lengthening of the first metatarsal while avoiding an interpositional bone graft. The technical aspects of the procedure are thoroughly discussed.