Modifications of the distal metaphyseal osteotomy to better facilitate use of the Herbert bone screw for fixation.

The Herbert bone screw was initially developed for management of fractures of the carpal scaphoid. Due to its unique features, the applications of this rigid internal fixation device have been expanded. The most common use of the Herbert screw in podiatric surgery has been for fixation of the Austin osteotomy of the first metatarsal head, for correction of hallux abducto valgus. Technical difficulties encountered in this procedure may have discouraged its use or led to discontinuance. These problems are addressed, and modifications in technique are suggested. The most important modification involves a change in the angle and orientation of the osteotomy.