Radwan et al. randomized 53 patients (64 feet) with mild to moderate HV. Interventions were percutaneous distal metatarsal osteotomy (modified Bosch osteotomy) (29 feet), and distal chevron osteotomy (31 feet).1 Operative time was seven minutes shorter in the percutaneous group. There was no difference in time to union, hallux valgus angle (HVA), intermetatarsal angle (IMA), range of motion of the 1st MTP, pain, and American Orthopaedic Foot & Ankle Scores (AOFAS). They did not evaluate recurrence ( I).

Kaufmann et al. performed an RCT comparing open chevron (OC) versus percutaneous V‐shaped osteotomy (PVO).² There were 22 and 25 cases, respectively. There was no difference in pre‐ and postoperative HVA, IMA, or range of motion between the groups. There was significantly better patient satisfaction in the PVO osteotomy at 12 weeks’ postsurgery. At six weeks and nine months, patient satisfaction did not show any significant differences. One patient of each group reported poor satisfaction. Complications in the OC group were two hardware removals and one case of hallux varus that did not need revision surgery. Complications in the PVO group consisted in 12 cases of soft tissue irritation, caused by the Kirschner wire (K‐wire) which was removed. Recurrence occurred in three feet of the OC group and one foot of the PVO group; these were mild and did not require revision (level I).

Lam et al. reported an RCT of 51 patients undergoing surgical correction of HV, comparing scarf‐akin (SCA) osteotomies versus percutaneous modified chevron‐akin (PECA) osteotomy.³ There were 26 subjects (27 feet) and 25 subjects (33 feet), respectively. Operative time was four minutes shorter in the PECA group, pre‐ and postoperative IMA and HVA were not significantly different between groups. The AOFAS scores did not show any significant differences between the two groups. In the SCA group, there were two subjects who developed mild second metatarsalgia postoperatively. This was managed successfully with orthotics, with no revision required. In the PECA group, six required screw removal. This complication was almost completely eliminated when the authors started using the internal oblique view to confirm that the screw was fully engaged in the bone at the time of screw insertion (level I). Two other studies are consistent with these findings.^1,3