{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:16:29Z","timestamp":1789773389786,"version":"4.0.1"},"reference-count":21,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[1999,12,1]],"date-time":"1999-12-01T00:00:00Z","timestamp":944006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[1999,12]]},"abstract":"<jats:p>During a 12-year period in which 878 hallux valgus corrections were performed, 18 patients (21 feet) with symptomatic hallux valgus deformity and an increased distal metatarsal articular angle (DMAA) underwent periarticular osteotomies (double or triple first ray osteotomies). They were studied retrospectively at an average follow-up of 33 months. The surgical technique comprised a closing wedge distal first metatarsal osteotomy combined with either a proximal first metatarsal osteotomy or an opening wedge cuneiform osteotomy (double osteotomy). When a phalangeal osteotomy was added, the procedure was termed a \u201ctriple osteotomy.\u201d The average age of the patients at the time of surgery was 26 years. At final follow-up, the average hallux valgus correction measured 23\u00b0 and the average 1\u20132 intermetatarsal angle correction was 9\u00b0. The DMAA averaged 23\u00b0 preoperatively and was corrected to an average of 9\u00b0 postoperatively. One patient developed a postoperative hallux varus deformity, and one patient developed a malunion, both of which required a second surgery. A hallux valgus deformity with an increased DMAA can be successfully treated with multiple first ray osteotomies that maintain articular congruity of the first metatarsophalangeal joint.<\/jats:p>","DOI":"10.1177\/107110079902001202","type":"journal-article","created":{"date-parts":[[2013,3,3]],"date-time":"2013-03-03T03:31:12Z","timestamp":1362281472000},"page":"762-770","source":"Crossref","is-referenced-by-count":89,"title":["Treatment of Hallux Valgus with an Increased Distal Metatarsal Articular Angle: Evaluation of Double and Triple First Ray Osteotomies"],"prefix":"10.1177","volume":"20","author":[{"given":"Michael J.","family":"Coughlin","sequence":"first","affiliation":[{"name":"Clinical Professor of Orthopaedic Surgery, Oregon Health Sciences University, Portland, Oregon; Private Practice, Boise, Idaho."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Carlson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[1999,12,1]]},"reference":[{"key":"bibr1-107110079902001202","first-page":"54","volume":"24","author":"Amarnek D.","year":"1985","journal-title":"J. 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A symposium at the annual Winter Meeting of the American Orthopaedic Foot Ankle Society, New Orleans, March 22, 1998."},{"key":"bibr9-107110079902001202","doi-asserted-by":"publisher","DOI":"10.1177\/107110079601700304"},{"key":"bibr10-107110079902001202","doi-asserted-by":"publisher","DOI":"10.7547\/87507315-82-12-616"},{"key":"bibr11-107110079902001202","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1097\/00003086-198106000-00011","volume":"157","author":"Helal B.","year":"1981","journal-title":"Clin. Orthop."},{"key":"bibr12-107110079902001202","doi-asserted-by":"publisher","DOI":"10.1177\/107110079902001203"},{"key":"bibr13-107110079902001202","first-page":"81","volume":"32","author":"Logroscino D.","year":"1948","journal-title":"Chir. Organi. 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