{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:47:39Z","timestamp":1787755659685,"version":"build-2784847793"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JBJS Essential Surgical Techniques"],"abstract":"<jats:p>Proximal rotational metatarsal osteotomy (PROMO) is a technique that allows the surgeon to correct the varus and pronation of the first metatarsal that is observed in most patients with hallux valgus deformity. Persistent metatarsal pronation is a recognized recurrence factor for operatively treated hallux valgus. The indication for this technique is a mild-moderate hallux valgus deformity (i.e., intermetatarsal angle &lt;18\u00b0 and hallux valgus angle &lt;40\u00b0) in which pronation is present. (Note that according to the literature, 10% to 20% of patients do not have pronation.) The PROMO is performed via a single proximal oblique metatarsal incision. Following completion of the osteotomy, the distal metatarsal segment is supinated (external rotation), correcting pronation and varus deviation, which is achieved as a result of the oblique nature of the osteotomy (i.e., rotation through an oblique plane). Step 1: Preoperative planning: measure the intermetatarsal angle and the metatarsal rotation. For the latter, use the published classification (mild, moderate, severe). With both values, use the table included in the PROMO tray to know which osteotomy angulation should be used. Step 2: medial foot incision. Step 3: drive the guidewire 1 cm distal to the tarsometatarsal joint. Step 4: Under fluoroscopy, ensure that the wire is parallel to the sole of the foot and perpendicular to the metatarsal. Step 5: use the positioning jig to drive a Kirschner wire with the chosen pronation correction. Step 6: slide the osteotomy jig with the previously chosen osteotomy angulation. Step 7: perform the osteotomy. Step 8: use the rotation jig with the desired pronation correction. Step 9: derotate and correct the metatarsal deformity, leaving both wires parallel to each other. Step 10: perform osteotomy transient fixation with 2 Kirschner wires. Step 11: apply a medial locking plate and an interfragmentary screw at the osteotomy site. The expected outcome is complete correction of the first metatarsal varus and pronation.<\/jats:p>","DOI":"10.2106\/jbjs.st.19.00010","type":"journal-article","created":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T09:43:45Z","timestamp":1576230225000},"page":"e43","source":"Crossref","is-referenced-by-count":14,"title":["The Use of a Triplanar Metatarsal Rotational Osteotomy to Correct Hallux Valgus Deformities"],"prefix":"10.2106","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4896-4434","authenticated-orcid":false,"given":"Pablo","family":"Wagner","sequence":"first","affiliation":[{"name":"Orthopedic Surgery Department, Cl\u00ednica Alemana de Santiago\u2013Universidad del Desarrollo, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7498-7480","authenticated-orcid":false,"given":"Emilio","family":"Wagner","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery Department, Cl\u00ednica Alemana de Santiago\u2013Universidad del Desarrollo, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019]]},"reference":[{"issue":"7","key":"bib1-20230808","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1177\/1071100716639574","article-title":"Long-term follow-up of a randomized controlled trial comparing scarf to chevron osteotomy in hallux valgus correction","volume":"37","author":"Jeuken","year":"2016","journal-title":"Foot Ankle Int."},{"issue":"6","key":"bib2-20230808","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1053\/j.jfas.2013.04.003","article-title":"Short-term clinical and radiologic results of the scarf osteotomy: what factors contribute to recurrence?","volume":"52","author":"Deveci","year":"2013","journal-title":"J Foot Ankle Surg."},{"issue":"10","key":"bib3-20230808","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.2106\/00004623-200710000-00010","article-title":"The shape of the lateral edge of the first metatarsal head as a risk factor for recurrence of hallux valgus","volume":"89","author":"Okuda","year":"2007","journal-title":"J Bone Joint Surg Am."},{"issue":"7","key":"bib4-20230808","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.2106\/JBJS.H.00796","article-title":"Postoperative incomplete reduction of the sesamoids as a risk factor for recurrence of hallux valgus","volume":"91","author":"Okuda","year":"2009","journal-title":"J Bone Joint Surg Am."},{"issue":"11","key":"bib5-20230808","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1177\/1071100716658456","article-title":"Tibial sesamoid position influence on functional outcome and satisfaction after hallux valgus surgery","volume":"37","author":"Chen","year":"2016","journal-title":"Foot Ankle Int."},{"issue":"5","key":"bib6-20230808","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1007\/s00776-015-0749-x","article-title":"Shape of the lateral edge of the first metatarsal head changes depending on the rotation and inclination of the first metatarsal: a study using digitally reconstructed radiographs","volume":"20","author":"Yamaguchi","year":"2015","journal-title":"J Orthop Sci."},{"issue":"8","key":"bib7-20230808","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1177\/1071100715576994","article-title":"A new measure of tibial sesamoid position in hallux valgus in relation to the coronal rotation of the first metatarsal in CT scans","volume":"36","author":"Kim","year":"2015","journal-title":"Foot Ankle Int."},{"issue":"2","key":"bib8-20230808","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.fcl.2018.01.009","article-title":"Is the rotational deformity important in our decision-making process for correction of hallux valgus deformity?","volume":"23","author":"Wagner","year":"2018","journal-title":"Foot Ankle Clin."},{"issue":"1","key":"bib9-20230808","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/BTF.0000000000000142","article-title":"Rotational osteotomy for Hallux Valgus. A new technique for primary and revision cases","volume":"16","author":"Wagner","year":"2017","journal-title":"Tech Foot Ankle Surg."},{"key":"bib10-20230808","first-page":"1","article-title":"Proximal Rotational Metatarsal Osteotomy for Hallux Valgus (PROMO): Short-term prospective case series with a novel technique and topic review","author":"Wagner","year":"2018","journal-title":"Foot Ankle Orthopedics"}],"container-title":["JBJS Essential Surgical Techniques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.ST.19.00010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:45:49Z","timestamp":1787751949000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.ST.19.00010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019]]},"references-count":10,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.st.19.00010","relation":{},"ISSN":["2160-2204"],"issn-type":[{"value":"2160-2204","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019]]}}}